Puncture wounds we have known

The recent "lost hiker" thread has lost its own way among tales of puncture wounds. Not wanting to continue down that trail and contribute tto the hijacking, I offer here an opportunity to recount your favorite puncture wound stories. Why? 'Cuz it happens in the woods and folks should know the risks and how to respond. Me first, with an account not witnessed by your scribe but told to me by the principal:

A guy and some other guys are in northeastern MN on a canoe trip. Guy #1 is gathering firewood. Being a guy and being fixated on efficiency (read: averse to tedious sawing, etc.), he commences jumping up and down on a largish branch attached to a deadfall. Branch separates from deadfall with startling rapidity and its stub immediately avenges itself on his throat. No carotid puncture, but the difference probably couldn't be measured without a micrometer. Buddies get pressure on the wound, paddle him out in the canoe, get in the car and drive the 60 minutes to the hospital in something less than sixty minutes. Successful stitchery follows thereon.

Your turn. (And if it involves an ice axe and an abdomen on the Eastern Slope, ya better have the picture -- it's just boring to hear it repeated again without the visual aid.)

My favorite puncture wound story is about how good SOLO instructors are at replicating the real thing with a stick, a hand, some putty, and some red dye.

So, you've got a 6" stick, 1/4" diameter, rammed through the palm of your hand. You're still a day's hike from your car. Should you leave it in place or pull it out? Why?

Waumbek said:

My favorite puncture wound story is about how good SOLO instructors are at replicating the real thing with a stick, a hand, some putty, and some red dye.

So, you've got a 6" stick, 1/4" diameter, rammed through the palm of your hand. You're still a day's hike from your car. Should you leave it in place or pull it out? Why?

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Remove it. 1/4 inch isn't going to do much damage. Whatever bleeding you have should be easily controllable. Puncture wounds don't usually bleed very much anyway, which is why they are so susceptible to infection. It is entirely possible that it would move most of the important parts out of the way as it went through. The hand should be pretty usable after removal. If you don't remove it he is going to be partially incapacitated. It is possible that not only are you going to have to stabilize the object but also the hand and maybe the arm. That is going to make self rescue much more difficult.

At least that is what I would do.

Keith

SAR-EMT40 said:

Remove it. 1/4 inch isn't going to do much damage. Whatever bleeding you have should be easily controllable. Puncture wounds don't usually bleed very much anyway, which is why they are so susceptible to infection. It is entirely possible that it would move most of the important parts out of the way as it went through. The hand should be pretty usable after removal. If you don't remove it he is going to be partially incapacitated. It is possible that not only are you going to have to stabilize the object but also the hand and maybe the arm. That is going to make self rescue much more difficult.

At least that is what I would do.

Keith

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Damn, removing something like that would hurt and I know for dang sure I could not do it myself

1ADAM12 said:

Damn, removing something like that would hurt and I know for dang sure I could not do it myself

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I'd remove it for you. Always helps to have a freind around.

Adrenalin can be your friend. I have had injuries hopped up on adrenalin that I haven't felt at all. Looking down and seeing that would cause a pretty good adrenalin rush. You would probably just grab it yourself and pull it out. I know, I have done that with a pretty good size nail in the heel of my foot. I stepped on a board with a large nail in it. With my other foot I stood on the board and lifted my impaled foot off of the nail. Felt much better with the nail out than it did with the nail in.

One other incident with a very large nail that went through my shoe and was poking out the top about 2 inches. Again, a very large adrenalin dump as the board was following me around as I was walking. Looked down and saw what it was and could not believe it didn't hurt. Lucky me, it passed between my big toe and the toe next to it.

Keith

1ADAM12 said:

Damn, removing something like that would hurt and I know for dang sure I could not do it myself

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I have read of cases where the doctor in the party was the victim and he directed others in caring for him. In one case it was stitching up his hand after some overzealous work with a snow saw. (on a mountaineering expedition.)

I also have a recollection of someone directing his own apendectomy using only local anesthesia... (I think this is real and not a legend. IIRC, it was at an isolated Arctic location.)

You may be surprised at what you can do when the incident actually happens.

Doug

One SOLO instructor I know (and certainly not all SOLO instructors) says to leave small projectiles in extremities intact. Bandage it in place and get the impaled out to an ER.

One M.D. I know (and certainly not all M.D.s) says to remove small projectiles in extremities to thwart infection.

These are not self-rescue scenarios, however.

There you have it.

DougPaul said:

I also have a recollection of someone directing his own apendectomy using only local anesthesia... (I think this is real and not a legend. IIRC, it was at an isolated Arctic location.)

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I'm not familiar with the appendectomy story, but a few years ago there was a woman who diagnosed herself with breast cancer while at an Antarctic research station, and had to perform her own biopsy and start her own treatment program until winter passed and she could be airlifted out.