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RAPID ASSESSMENT

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Amy Umble is health reporter for The Free Lance-Star

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Rescue of impaled man was ‘textbook’

The accident scene at St. Mary's Catholic Church in Fredericksburg.

Both fire department and hospital workers described Friday’s rescue of the construction worker who was impaled on a steel reinforcing rod as “textbook.” Everything worked as it was supposed to, they said. Quick care, combined with incredible luck on the part of the worker, means he’ll probably be OK.

David Morris, lieutenant for the Fredericksburg Fire Department, said a number of questions were going through his head as he arrived at St. Mary’s Catholic Church, where the accident occurred. These included:

1. What are possible internal injuries to the man, based on the angle of penetration of the rod? What organs might be involved? (Turns out the only injured organ was the man’s diaphragm.)

2. How stable is he? (He was conscious but in great pain.)

3. What do you have to do to maintain that stability? (Rescue workers gave him oxygen, intravenous fluids and pain medication.)

4. How do you move him without causing further injury, and how can you do that quickly? (He was “packaged” with cervical collar and head blocks on a backboard. Trauma dressing stabilized the 5/8-inch rod, and an occlusive bandage, slipped over the rod, covered the man’s chest wound.)

“You don’t want to stay on the scene any longer than you have to,” Morris said. “We’ve got a level 2 trauma center now, use it.”

Dr. Lawrence Roberts, medical director of the trauma center at Mary Washington Hospital, said that the crew radioed ahead to say that they would be there in about seven minutes. Arrival time was closer to 15 minutes, Roberts said, and this allowed the trauma team to get ready.

Preparations included getting an operating room, anesthesia support, nurses, equipment and blood products. Three trauma surgeons worked on the man, and two other surgeons stood by in case they were needed. The man was in surgery for more than three hours.

“In the operating room we were able to look inside and look at the entire trajectory of the rebar through his body,” Roberts said. “Remarkably it injured very few internal organs. Absolutely amazing.”

Roberts said there was no thought to flying the man to another hospital.

“There was no reason to,” he said. “We really had everything available to us.”

Update: Kathleen Allenbaugh, spokeswoman for the hospital, said this afternoon that the worker, Otoniel Lopez, has moved out of the intensive care unit and is in good condition.

(A story about the accident appeared in Saturday’s paper and can be seen here.)

Permalink: http://news.fredericksburg.com/rapidassessment/2010/04/26/textbook-rescue-of-impaled-man/