Darwin

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

Don't quite know what to say about this one.

Responded to a shack on a native reserve for a "sore foot" at 4am, injury apparently occurred 2 or 3 days ago. Found a late 30's male in the early stages ETOH withdrawl complaining of foot pain related to the following:

While on a drinking binge (don't even ask what all was involved, many of
the substances would not be allowed for human consumption by the FDA) and went outside (barefoot) in the middle of the night (at -30) to pee -no running water or electricity in shack. Porcupine that had been stealing dogfood(?) from a bag under the porch tries to escape through the gap between stair risers and run off to wherever. Our winner punts him with his bare foot. MANY needles become imbedded in foot, and the side of his leg when the aggravated critter takes a parting swipe at him with its tail. 

All of this no doubt hurt a little, penetrating his alcohol induced state, so he goes back inside and increases his consumption rate. At some point over the next day it really bothers him, so he fills a bucket with snow from the porch and puts his foot in it (after trying to pull out several needles with pliers from a toolkit in the corner next to a torn down Chevy engine). These are now quite infected, and broken off below the skin level. 

Snow level decreases due to warmth in shack, so he lets the woodstove die out and keeps bucket full. Soon he "can't take it any more" and sends his drinking buddy in to call an ambulance as he wants us to give him a ride to town so he can get some more "medicine". He claims he learned how to be a medicine man from his grandfather and doesn't trust Whitey's doctors to fix him - he'll do it himself. Buddy apparently left before dark - on foot, and called us from a payphone on the highway to town. Was not at the phone when we went past it on the way to the "residence".

Patient is hypothermic (no fever found despite infection), foot is infected, full of needles, and frostbitten in several places, patient is seeing things on the walls (which he claims are spirit visions) and has pronounced tremors in extremities (as well as shivering) with a glucose level of 3.1  He has no footwear beside thin leather moccasins which he refuses to wear due to needles (fair enough) and his nylon/fleece jacket was hung on the chimney and is snow basically melted to it. He does have leather work gloves (uninsulated, with fingertips mostly worn/burned off) and a muskrat hat. 

The ground crew had to walk almost 1/3 mile through 2' of snow (plus many drifts up to 3.5 feet high) from the gravel track that runs in front of his property because the 4x4 ambulance is in the shop right now. The local SAR team (45 min away) has skidoo's for searches but no patient capable toboggan. They left the stretcher in the ambulance (god cal) and took only a Ferno #9 in with their kits. The closest volunteer fire department has no SKED (sold it off 2 years ago as never used it in-town and to complicated to maintain proficiency with) they could bring so a flight was called for access reasons. 

55 min flight time plus 10 min response lag later your BK 117 arrives at a LZ marked out in the snow by burning coffee cans full of oil/lamp kerosene and toilet paper, off about 200m to the side of the cabin in
a clearing. With help from the ground crew the patient is carried to the helicopter and flown to a regional center. As you are cleaning up/drying out back in the hanger you hear that he refused treatment in the ER and walked out AMA (in his bare feet at -18).....

Was apparently arrested 2 blocks away under mental health provisions and
is now back in ER.

Fly Safe. 
Ken L-W CCEMT-P/RN/WMT

"For extreme illnesses, extreme treatments are most fitting"    Hippocrates

_____________________________________________________________
Get yourname@FlightMedicMail.com:
Sign up at http://www.FlightMedicMail.com

_____________________________________________________________
Select your own custom email address for FREE! Get you@yourchoice.com w/No Ads, 6MB, POP & more! http://www.everyone.net/selectmail?campaign=tag

_______________________________________________
Flightmed mailing list
To unsubscribe or change your email address, go to http://www.pairlist.net/mailman/listinfo/flightmed