About a year ago a friend and I were checking out a house, looking to buy a rental property.

About ~5min away from where we both work. We’re standing in a parking lot discussing the house we’d just walked through. Hard to describe, but this parking lot is at the top and to the side of an overpass, which runs over a highway.

I hear some screeching brakes, see a guy abruptly stop at the stop of the off ramp, open his car door, jump the barrier and bolt.

Not knowing what was happening, buddy and I take off running, we run across the top of the bridge and hear a couple people yelling “he jumped”. As I’m running across the top of the bridge to the far side, I can see a body laying in the street below.

Somehow me and that guy who’d stopped his car get to the guy at the same time, I tell him I know first aid. When we get there, the guy in the street is still breathing, albeit somewhat laboured. We put him in the recovery position.

My friend that was with me has called 911 at this point and started directing traffic. Me and the other guy are with the dude laying in the street, he’s obviously ****ed up, but still breathing, literally mins after the ambulance shows up and is backing towards us the guy stops bearding, they cut his **** off and throw on the defib, they work on him for 10mins, nothing works and they end up loading him into a body bag.

He had a hoodie on when we got there. When the paramedics got there they cut his shirt off and took off his hood. He was somewhat bald, and you could see the huge bruise that had already started to form on the top of his head.

Nothing you could have done. The survival rate for blunt traumatic arrests is zero point zero. With very few exceptions, paramedics in our area don't even bring those patients to the trauma center any more.

MM MD

Is this only for initial lifesaving measures or does it include TBIs or other long term neurological issues? I guess what I’m getting at is, are the paramedics and/or hospitals choosing not to bring in such patients because they likely won’t initially survive or because even if they do survive, the quality of life would be terrible?

This is great.

I don't believe I have anything to contribute, but cool thread.

I work at the railway and we get a fair number of suicides when people jump in front of trains. It’s never very pretty.

Just for blunt traumatic arrests - meaning no pulse/respriations/pressure. You can have a huge brain ding and you'll still circulate blood - those people get brought in and on RARE occasions actually do sort of OK (meaning a better outcome than "drool to gravity".) - I'm thinking of one case where a guy had a HORRIBLE looking head CT, but walked out after a couple of weeks in the ICU. Dunno how sharp he was after the accident, but he made it.

To have cardiac arrest from a blunt injury you nearly always have an aortic/great vessel/cardiac disaster. Those people would die even if I was at the accident scene ready to go - you put your entire blood supply round the circuit in a few minutes, and if the blood is dumping into your thorax/abdomen instead of perfusing your vital organs, you're toast.

MM MD

Winner

What if it dumps lower? Could this cause a major priapism?

If it's a problem for you, they have pills for that.

MM MD

Don't sildena-fill me with ideas, doc.

I haven't been itt thread for days, I was expecting much more from a degen forum.

Yeah, what’s the deal? Maybe they’re advised by their legal council not to share such stories at this point in time.

It's messed up but 10 years ago this thread woulda been packed. I think I might post this thread on my other degen forum, it's filled with ex Rogan Board peeps. It will probably include a lot of fighting and drugs.

Fun stuff!!!

Copy and paste the good stories and claim them as your own. It’ll keep the thread alive and make it seem like you’ve had an insane life!

MM MD wins the thread

I'm 3 months into a new nursing gig, the coolest I have is:

one day I'm working night shift, a patient starts having chest pains at 3:30 a.m.

Call Rapid Response, we slap on the 12-lead EKG, check vitals, she's reasonably normal, so we give her some nitro, and she's ok

I hope that's my closest brush with death (personally or professionally) for a long time

Ventricular fibrillation is good, because it's one of the few things where a shock can do some good, and having an AED on the premises could possibly save a life

One more, just for amusement. I get called to the trauma bay to see a guy who rolled his car on I-80 about an hour east of town. But when I talk to the patient, our charge nurse misunderstood – he didn’t roll his car, he just informed his wife that he was dizzy, pulled over to the shoulder, and passed out for a minute. After a couple of shakes by the wife, he woke up. Fortunately, they had cell service, called the medics and they brought them to us.

The trauma surgeon loudly announces this isn’t a trauma, (YOU THINK?) so he’s signing off. Which I’m fine with – I think this is more of a medicine problem anyway. Patient has no pain, no shortness of breath, nothing. I take a listen to his heart – BIG murmur – huge WHOOSH at the end of every heartbeat. I call the cardiologist and tell him I need a Stat echocardiogram (heart ultrasound) – I can hear the eyes roll on the other end of the phone, but he OK’s it. 20 minutes later I get a call and am informed that I’m a ****ing genius, the patient has critical aortic stenosis, and the cardiologist wants the patient admitted to the CCU until the heart surgeon can give him a new valve.
Which all makes sense – people with aortic stenosis pass out when their partially occluding valve tightens up a bit for some reason, decreasing outflow from the heart. No outflow, no blood to brain, and you pass out. If you’re lucky your valve loosens up again and you wake up, but sometimes patients with the problem die dramatically and finally.

I go back to tell the patient and his wife the score. In all honestly, I went back to talk to him and his wife because they were both really pleasant people. He feels fine now – not dizzy at all. “Anything else bothering you?” I ask – now that you mention it, I have a little pain on the right side of my abdomen. Nothing on the left, nothing in the back. I re-examine him – nothing – no increased pain, no pulsatile mass. I start at him for a solid two minutes – something just smells bad about this to me. I send him over for a STAT CT of his abdomen – 10 minutes later I’m called over to see a leaking aortic aneurysm that for the moment is contained. Of course, they tend to rupture pretty quickly and since you put your entire blood supply thru your aorta every 5 minutes, that’s not good. I call the vascular surgeon but before we can even get his office on the line he walks around the corner into the department. I show him the scan, he whistles appreciatively, and takes the patient immediately to the OR and stent his AAA. A week later, he gets his new aortic valve, and walks out of the hospital.

I would have been totally justified in sending him up to the CCU – his aortic stenosis completely explained his passing out episode. Within a couple of hours, he would have died suddenly, when his aneurysm ruptured, with no one the wiser – as I noted above, people with aortic stenosis have the nasty habit of dying suddenly. If he'd been a jerk/pain in the ass, maybe I don't go back to chat again. Which is why I tell my students and residents to listen to that little voice in the back of you head warning you to take another look….

MM MD

My takeaway: always be nice and respectful to any medical professional examining you.

When my friend was an intern they brought in a girl who had jumped off a bridge into very cold water. The doctor declared her DOA, and told my friend to practice the procedure for treating someone with severe hypothermia, since it was a corpse and she couldn't do any harm. The doctor left, my friend started going through the steps, and after a while noticed a heartbeat. She said the girl fully recovered and was "really not happy" that my friend screwed up the suicide.

The mantra is always "You're not dead until you're warm and dead" - if your core temp is below 90 or so, we're gonna work you by warming you up. The best way to warm up a cold dead person is still a bit up for grabs - we generally use a "bear-hugger" which looks like a giant sleeping bag that has hot air blown into it. In the past, more dramatic methods were used, like putting in bilateral chest tubes and running warm saline in and out. Despite what you read about, the vast majority of cold dead people stay that way, but very occasionally (most often in kids who fell into very cold waters) you get a miracle cure.

MM MD

OTOH, any ER doc will tell you the best indicator for a horrible outcome/diagnosis is to be a nice person. "She's a really nice person" - is generally followed by "So, you diagnosed cancer, huh?" - we're a sort of morbid bunch in the ER.

MM MD

About 20 years ago, I was driving on the freeway when the car in front of me crashed into the median for some reason and spun out across all lanes of traffic. They went over the side of the road and down a steep hill. I was the only one who pulled over. Ran down the hill, engine is smoking, horn going off, nasty airbag smell in the air. I pull open the driver side door and see two old women inside. I get the driver out and she asks, “is my tongue ok?” She sticks her tongue out and she had bitten half of it off. I told her she was fine and went around to the woman in the passenger seat who was dazed. I open the door and she immediately tells me she can’t breathe. At this time, another guy had stopped to help but he was really just standing there watching. I had him call 911. Passenger lady says she needs to get out to breathe so I take off her seatbelt and noticed some pretty bad cuts where the belt had been. I figured she may have broken some ribs. She puts her leg out to step out and I saw it start flapping in the air right at mid shin. I yell at her not to stand up as it is apparent her leg is broken. She starts screaming in pain so I kneel down to hold her hand and talk to her. As I do so, I’m looking right at her tibia (shin bone) ripped out of her skin staring me in the face. I talk to her a bit and the ambulance shows up. I don’t know if they had to shove the bone back in right away or what but they did something to her leg that made her scream in pain like I have never heard. They took her to the hospital and I have no idea how she ended up. She was pretty banged up, though.

Hobbes, love your stories!


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Almost attacked by a king cobra.

Electro-shocked in my shower.

Circled by a pack of dogs and a nearby vendor threw out a fire cracker and they dispersed.

Multiple driving scenarios, kind of forget them, though.

Pack of dogs and vendors with firecrackers? What country was that?