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Just had a guy leave here a few minutes ago with his left pinkie finger in a cooler on ice. Cut it off with a radial arm saw trying to cut a very short piece of wood. We also think he had his hands crossed while he was cutting it, but don’t know for sure.
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Did you hear that sound? Of my gut wrenching? Good luck to your guy.
Andy
*Just looking at a RAS always makes my hands tingle. In my mind I see all these safety flags around the saw. It sucks to have accidents as the primary learning tool for safety. Tell your guy I know personally how it feels to lose a body part- it's really the sh*ts, and depressing. He'll eventually be just fine. Best wishes for a speedy recovery. -Ken
*Just found out that the guy's finger can't be re-attached. But they can use some of the skin from it to graft over the end of what's left. He's 20 years old, and now will have to go through the rest of his life without that finger because he didn't pay attention to the things he was taught: 1. Don't cut really short stuff.2. Don't cross your hands when you're cutting things. 3. Keep your hands away from the blade.
*Good luck to your coworker, just talked to a pal of mine that had a grounding stake driven thru his hand about two years ago. Still in therapy, still waiting on comp, still working and with minimal use of his left thumb. Boy, he says he still feels dumb, but not half as dumb as our old boss who fell thru a rotten perlin and broke his ankle. Be safe out there.
*Guess it's kinda late now, but - What's the correct way to transport a severed body part to the hospital? I've heard that it should be on ice, and that it shouldn't. Which is correct?We put this particular finger in a drink cooler. (It was all I could find on short notice) I put ice in the bottom, then put the finger on top wrapped in paper towels. Didn't spend a lot of time thinking it over.
*"Three finger Brown" is a pretty cool nickname, you gotta admit.
*> What's the correct way to transport a severed body part to the hospital? I've heard that it should be on ice, and that it shouldn't. Which is correct? What you want to do is get it as cold as possible without forming any ice crystals within the tissue, and without allowing water to soak into the tissue. The way you did it was fine, it would have been a little better if you could have put a wrap of plastic around it before the paper towels. That would keep water from soaking into the finger. Of course you had water in with the ice to transfer the heat, right?-- J.S.
*I've also heard it can be done like a knocked out tooth- keep it in your mouth. Right or wrong? Any MD's or EMT's here? -Ken
*Sounds like losing a body part would be a reason to sing the blues, and with a name like that he's ready. Even if he can only pick the guitar at three-fifths speed.
*after i suffered a coma in '94 (doing a lot of ac service on rooves + serious workload after the northridge quake), i rethought doing any kind of maintenance/construction.during my recovery, i recalled an old italian gentleman that partnered with my father to do masonry. i remember thinking how i'd never do construction after looking at the toll it had on him - breaks in hands and arms and missing body parts. i was going strong until the coma.also vividly recall a tub refinisher's foot-long scar from his operation. had a lung removed as a result of painting with the urethanes. partner of mine (with 20 years experience) cracked his head open after falling off a ladder while reaching out to cut a bush with a trimmer.a guy working in a new chlorination room at the local water company went to put a screw in with his cordless and blew himself out the roof. the stories go on and on. i'm back in the practice. watching coworkers shoot nails & drills into their hands, falling off ladders while talking on their cell phones, getting cortisone shots for tendonitis, ... there are no purple hearts given in this field. the guys working at the World Trade Center are as brave as they come, but i'm sure that they are also as circumspect as they come. awareness is the key. doesn't sound like your coworker was qualified to be working with that equipment. he's young. hope he bounces back okay.regards,brian
*probably stick to playing bass.
*What's wrong with cortisone?
*nothing. it's great. but tendenitis isn't :-( the guy now where's a brace. only in his mid-20s.brian
*Boss, according to the Red Cross training manual for first aid, the preffered method of transport for severed digits is to place them in a plastic baggie, then put the baggie in a cooler with ice and water. But, any attempt to keep the body part with the patient on their way to the hospital is better than none.
*Knocked out teeth are best transported in milk. Most close to it's natural environment.
*I drove a friend 60 miles to Anchorage once holding his thumb in his hand....he chopped it off while splitting wood. They actually sewed it back on and he regained usage. it was detached at least 1.5 hours.
*Thanks to xJohn and Tim for the info. Never thought about keeping it dry - Guess the paper towels would have soaked up water pretty fast. I wasn't 100% sure what to do, and everyone was pretty excited. I was more concerned about trying to calm them down so they didn't kill themselves on the way to the hospital.
*Many moons ago my older brother moved a ladder, looked up at the noise and caught shards of the broken light fixture in his eye. Micro-surgery was still new at the time, but he regained use of his eye with only reading glasses. That's lucky.A bridge painter that I have seen climb like he had a "defy gravity for free" card, didn't bother tying off while sand blasting. The hose handle broke and he was blown off the bridge 60 feet down to the gravel grade below. He lived...with several broken ribs, arm and leg fractures and a few broken vertebrae. He was near retirement.
*I'm not an EMT, but have a fair amount of advanced first aid training. The EMTs who taught us said, put it in a bag, surrounded by wet paper towels, put that in another bag, and put that on ice.The idea as others have pointed out to keep it cold, but not wet and not frozen.
*The local electric utility company here gets barbs from people when they see a crew of 6-8 with 2-3 trucks, and nobody seems to be working fast. But you know, they all get to go home at night. Safety is number one with them, and it would be for me also working around high voltage hanging off a ladder or cherry picker bucket.
*Actually the best way to care for amputations is to think of them as two open wounds where the facia has been penetrated. Clean them both with sterile water, or as clean as possible. Try to not use a tourniquet to stop blood flow as that will cause further trauma. Keep both wounds clean and moist with no ice crystals or further trauma to either. Transport the patient and the parts and pieces at the same time. Don't forget to keep the patent warm and be on the lookout for shock.If at all feasible call your local EMS and let them do the transport. They not only should know exactly what to do; they should have the tools to take care of the patient if a further problem develops.Remember you are dealing with a potentially hazardous substance, human blood. So take protective measures yourself. This includes latex/nitrile gloves, eyewear, and shields. Clean up the area afterward to make sure no biohazard exists. It really ruins your day to find that you saved someone's finger only to have been exposed to Hep C, HIV, or some other life changing bug.
*Do you drug test on accidents?
*I guess you can nickname the saw now "Jaws".
*Yes, in a plastic bag. On melting ice (run water over it first) or in ice water.As stated, you want it cold but not to freeze (ice crystals cause damage like in frostbite.You want to keep it from drying out, obviously - the plastic bag does that. But you also do NOT want the body part in excess water. Osmostic pressure will cause water to move into the tissue, causing it to swell. It will also dilute the salt, blood, etc from the tissue. That stuff is supposed to be there and in their original concentrations.Clean is good. Sterile is great. But don't waste time and effect to do so. They'll get lots of antiboitics for any amputation. Look in the kitchen drawers. Food-grade materials are pretty good. Not sterile but good enough in a pinch. Peel off the outer foot of plastic wrap and use the newly uncovered stuff. Or better yet, take an unhandled zip-lock from the center of the pack.My doctor, one of wife's partners, can only count to 9. He's about 2 days from the finish of the Iditarod right now, with one glove finger flapping in the breeze. As a teenager he tried clearing a blocked snowblower without cutting the power. Once cleared, it blew (fingers). He nervously worried one so much on the drive to the hospital that they couldn't reattach it 20 years ago.I had a first aid student whose husband was in a hideous auto accident. He remembers, before losing consciousness, seeing an arm across the road and recognizing it as his own. It's reattached, works, and he was still getting more nerve function back as time went on. In plastic, cold, not freezing. Remember Mr. Bobbit's missing piece lay on the lawn for some time and it was successfully reattached. Didn't he make a porno flick demonstrating its functionality? -David
*Bobbitt Joke For You:Two guys are driving a pickup down the road when Lorena Bobbitt drives by going the other way and throws John's member out the window. The member bounces off the windshield of the pickup before ending up in the field where they found it."Wow!" says one of the guys, "Did you see the %$*# on that fly?
*Every truss company I've ever worked for drug tests after accidents. And I think it's appropriate. I also like the idea of random drug screening, and an occasional walk through with a police dogs. But I've never worked for a company that did those.
*Boss- Know a guy who worked for a truss co. here in Olympia. Said there were some serious dangers with the metal joiners that are rolled on. Razor sharp. -Ken
*Here is an article where three guys were being hoisted on a 250' cell tower by a rope tied to a pickup.
*Ken - The plates are definitely sharp. Cuts aren't at all uncommon, but are generally not serious. Most of them are just deep scratches, since the teeth are only 1/4" long more or less. Once the guys get used to handling them carefully (and build up callouses) cuts are fairly rare.
*MikeIt sounds so unbelievable I wish it weren't true.100 feet and they were still going?One inch ROPE?gawd awful, man.
*Hauling somebody up by a 1" rope connected to a pickup truck is pretty much out of line for this day and age, but it wasn't too many years ago that things like that were the norm. I worked for a while as a "high scaler". Perhaps a strange choice for someone who is a genuine acrophobic, but we only worked up to about 70' (being off the ground paid an extra $0.25 an hour, which is why I did it). However, as someone pointed out if you fall 70' onto jagged basalt rock you are undoubtedly just as dead as if you fell 700 feet...Anyway, our standard rig was to take a jackhammer and drill a drill rod into the ledge at the top of the cliff. We then tied a 3/4" steel cored rope around the drill steel. We then tied a slip knot with soft 3/8" rope around the 3/4" rope which was tied by a "D" ring to a belt around our waist. We then threw a jackhammer over our shoulder and stepped off backward over the edge of the cliff. To go down, you put pressure on the top of the slip knot. To stop, you just let go of the knot. One time we were operating a rockdrill into the face of the cliff that took two people, so they rigged a small platform snpiy two feet by four feet that was lowered using the 3/4" rope but they felt the individual ropes would get in the way so we worked on the platform about 50' up, and which was covered with drilling mud, with no safety lines at all. No one was killed, but one guy, who had planned on being a professional football player in the fall, tied his slip knot upside down and went express to the bottom of his rope - broke both ankles. That was around 1960. We also had no eye or hearing protection when running the jackhammers either. But that was the norm for the time. (For a long time I thought that might have been part of the reason that I have lost most of my hearing, but it turns out that the problem is autoimmune problems. But that is another story...)I tried to tie one of those slip knots the other day and couldn't get it right. It is sort of like a hangman's noose with multiple wraps of the 3/8" rope around the 3/4" rope. The more wraps around the main rope, the slower you went down - I think we used about 5 or 6 to give us some speed. I've looked in several knot books, but haven't found it. Anyone remember how to tie one of those things?
*Casey,Are you thinking of a prussic knot? Take a length of small rope and tie it into a loop (w/a bowline). Lay the loop over the larger rope and pull the end of the loop around the rope a couple of times, inside the loop.The prussic will slide when there's no pressure on it, yet locks up tight when it's under load.Talking about jobsite accidents, I attended and drove an ambulance many years back, and saw a few jobiste and industrial accidents. Many of the victims told me that what they were doing "didn't feel right", but they did it anyway--usually when tired, often at the end of a shift.The lesson I learned was to listen to that little voice that says "this is dangerous, I (or someone else) could get hurt". Stop and reposition the ladder, get the goggles, tell the guy to move out of the way,...whatever.Cliff
*Casey: Yes, a "prussik" knot would be the ticket. Any rock climbing book will discuss its use. A Bond-007 flick (the last Roger Moore one?) had him removing his shoe laces and prussiking up a rope to a Monestary sited on a stone pinnacle. Personally, I have 6 to 7mm perlon in my caving pack for back-up use only. My primarily ascenders are aluminium, cam-locking ones by Petzel (search http://www.rei.com for pictures). -David
*Speaking of the "good old days", I worked with a geologist who used to log bore holes, "in-situ". That is, they would lower him down an 18" bore hole in a bucket. He'd hold a flashlight in his teeth and write down the various layers and formations that had been driller through. What you have to understand is that, frequently, wells "cave" if left open. If that ever happened while a person was inside, they'd be toast. Very flat toast. He mentioned that 18" of sky looks VERY small when you're 80 feet down. -David
*Hey Boss, sorry to hear about your guy's loss... hope he makes it through alright. Dave, you're right on as far as what to do: First and foremost, CALL 911. The few minutes that it takes us to arrive is worth it in the long run. Before worrying too much about the amputated part, worry about the person that it was once attached to. Reattachment doesn't work too great if the patient is dead :-) Apply a bulky dressing to the wound and apply firm and even pressure to slow/stop bleeding. Elevating the limb also helps greatly if at all possible. DO NOT and I mean DO NOT apply a tournequit unless it is impossible to control bleeding any other way - in other words keep trying. Have the person sit down and try to keep them calm. If they begin to show signs of shock - cold clammy skin, sweating, paleness, nausea, etc. - lie them down on their back with their feet elevated. As far as care for the amputated part, keep it dry, clean, and cool. The best route is to quickly rinse the part and wrap it in clean gauze (assuming you have some) This then gets sealed in a plastic bag which then gets placed in another bag of cold water. NEVER place the part directly on ice or in water. It will destroy the tissue rendering reattachment impossible. All in all, get the person medical attention ASAP. Hope that helps guys - Nick
*A friend of mine was a junior engineer on a large site in central London and had to descend to the bottom of every pile-hole (40' down) in the crane bucket to inspect the footing.
*Anybody have any suggestions as to the best type of shoes for roofing. I recently finished a composition roof 7/12 pitch. My shoes didn't give me really great traction, any suggestions?
*Has anyone tried rockclimbing shoes on a roof? About 1984 Fire came out with really sticky rubber on their climbing shoes. You could press them lightly against a dime and pick the dime up from the friction. I suspect they've got even stickier compounds now. This assumes that the granules aren't coming lose. If they are, it doesn't matter how sticky your shoes are, come back on a cooler day or work from staging.A trick people that old-timers in icey climates use is to put bleach on your shoes. It makes them stickier on the ice. Since it works for drag racers (with their tires on asphalt), it might well work for roofer on asphalt composition shingles. -David
*I've done rock climbing here in NY at The Gunks. MAybe did a bit better then 7.5's but the point about rock climbing shoes is that they are very very tight. Spose you could get a pair that fit well but the rubber on a roof I think would wear em out pretty quickly and at ove a $100 a pair....I saw an ad in FH for roofing add on to your existing shoes. Looked interesting Also....the end of the day is almost always the time of accidents. When I do something minor through out my day such as smash my finger with a hammer...somethig minor...I look at it ALWAYS as a warning that I'm not paying attention. Its gotten me to age 51 and 27 years in the biz with all my body parts
*Advice from an ER doc. This essay started out short, and ended up long. I hope it's helpful.John Sprung's advice is exactly correct. Do it that way. DON'T wash, try to disinfect, sterilize, or otherwise cause further damage to already damaged tissue. This applies to both the amputated part and the remaining attached part. Cover thei attached part with a slightly moist dressing (clean water is ok) and get the guy to the nearest ER ASAP. Teeth belong in mouths. Fingers do not. Milk is for babies to drink. It doesn't help fingers. Pick up any pieces you can find, even if you think they're worthless, but don't waste time searching. If someone finds something after you've left, he can drive after you.The method of transport depends on circumstances. The goals are, in this order: to protect the life of the patient: the lives of others; and the limbs of the patient. There are many surgical urgencies, not very many surgical emergencies. In most cases, hours will do. Minutes are not required.Exceptions are limb amputations, where the amputated part needs to be reperfused with blood ASAP to keep it alive, and massive blood loss, where the patient needs IV fluids ASAP to keep him alive. Thus, in the case of an amputated finger, the best bet is to do the above, put him in a truck or car, and take him to (best case) the ER of the nearest hospital which has replantation capabilities or (second best) to the ER of the nearest hospital. This is because early reperfusion is essential, and a little bumping over ruts won't damage the patient, nor can an ambulance do any more than what John Sprung has already done.But what is even more essential than an attempt to salvage an amputated finger is that all of you arrive at the ER alive. Don't run any red lights, don't drive 100 mph on the freeway. Drive rapidly but legally. In the case of an amputated leg, say, the patient will have massive blood loss, and needs IV fluids to refill his cirulatory system, or he will die. His life comes before his limb; and in any case, it is very unlikely that a leg can be successfully replanted. So you stop the bleeding with direct pressure and call 911.If flesh and a foreign object are entangled, do not try to separate them unless they just come apart without force. Leave embedded objects in place and move both the patient and the object. If you can't move the object, call 911. Firemen know best how to separate the injured from the things that injured them. If they do separate, try to bring the object with you to the ER. Sometimes seeing the wounding object helps to determine the extent of the injuries, especially with stab wounds. If someone has a nail through his foot, bring a similar nail if you can. Don't bother bringing in blades that have cut something off, though. If there is significant bleeding, stop it with direct pressure with whatever is available. If you don't have sterile, use clean; if you don't have clean, use dirty. Use rags, paper towels, napkins, clothes, wadded newspaper, hands, anything. Duct tape is excellent for firmly compressing bandages and splints. I HAVE NEVER SEEN AN INJURY WHICH REQUIRED A TOURNIQUET TO STOP BLEEDING ENOUGH TO SAVE A LIFE. Don't use this barbaric implement.If amateur transport (you) is likely to damage the patient more, then use professional transport. Thus, someone who has a scalp laceration from sheet metal can hold a rag to his head while you drive him in. But someone who is unconscious from a heavy blow to the head may have a spinal fracture, a wound that penetrates the skull, or other internal injuries he can't tell you about. Don't move him at all, unless he is in danger or isn't breathing. Call 911. UNIVERSAL RULE: An unconscious person always has a fractured spine till proven otherwise. This requires an X-ray.Closed fractures are almost never emergent, just urgent or even non-urgent. They can be splinted, without trying to straighten anything, with cardboard (which is the best; you can x-ray right through it), wood, rebar, rolled-up newspapers or magazines, and some duct tape. Someone who can walk, or who has an injury below the knee, can probably be transported by pickup. Any possible fractures above the knee, or to the spine, or open ("compound") fractures, or when the limb is highly unstable, need 911. Your best bet, in general, is to be forwarned and forearmed. When you work at a site, find out where the nearest hospitals are and how to get to them. Certain services are available at only a few hospitals: this includes replantation and neurosurgery. Replantation is very expensive and requires specialized facilities and personnel. Severe carbon monoxide poisoning is greatly benefited by using hyperbaric oxygen therapy, but only a few hospitals have HBO chambers. If a guy cuts off a finger and you drive him 15 minutes to hospital A, which can't help him and needs to transfer him to hospital B, it will add a minimum of 2 to 3 hours to his reaching definitive treatment; but had you driven him 25 minutes to hospital B in the first place, he would be getting definitive treatment within an hour of arrival.Someone who needs a neurosurgeon will almost certainly be transported by ambulance, and the crew will know where to go.A call or visit to the ER of the local hospitals should give you info on where to go for a particular service. Mapquest.com will give you directions from your site. I would suggest that you print up enough of these directions so you can post them in all vehicles at the site, in all the languages needed, with, maybe, brief instructions attached, e.g.: "If part of a hand or foot is amputated, drive the patient to Blue River Hospital; for all other injuries and illnesses, drive him to Lincoln Memorial Hospital." If ever you or your crew is in doubt about whether to self-transport or call 911, then call 911.My fundamental message is: use your common sense. People in the building trades have more common sense than 95% of the population, so don't be afraid to use it. Medicine, especially surgical type medicine, deals in concrete objects that happen to be biological, and the principles of dealing with flesh are similar to those of dealing with non-biological objects. Yes, some of it is mysterious, but most of it isn't, and can be comprehended by any intelligent non-MD. Sorry to run on so long; I hope that this is helpful to some of you.
*To simplify all that has been said:If a person has an amputation first of all think of your own safety. Protect yourself from that person's body fluids by using gloves, glasses etc. Don't create a second victim by catching any diseases that person has.If at all possible call 911, or the emergency number in your area. Let the pro's do the transport. If the patient goes into shock, needs pain meds, fluids, or whatever they have the tools to do the job. Plus, if there is a choice of hospitals they'll know which one to take the patient too.In my earlier post I assumed everyone knew how to handle an amputated part. That apparently wasn't a good assumption. So, just keep it moist but not wet and cool, not frozen. DAMP gauze on the part; the part in a plastic bag or plastic wrap and in slushy ice or cool water.Control bleeding with pressure dressing on the wound if at all possible. Still bleeding? Add more dressing and pressure.If you have to transport keep the patient and the parts together and keep the Patient warm and lying down.If you absolutely have to transport remember that even ambulances running lights an sirens and with trained drivers don't exceed the speed limit on most runs. So, take your time and every one stay alive.Always think about your own safety and security first, then the patient's.
*Stephen, thanks for the excellent post.Andy
*If you're interested in being better prepared for emergencies and disasters, here's a great place to start:http://www.cert-la.comThe Los Angeles Fire Department long ago came to the realization that in a major earthquake, there'd be far more to do that they could get to, and that their people and equipment would be unable to reach some of the worst problems due to damaged roads and bridges and collapsed buildings. So, they started the Community Emergency Response Training program to help the people who would try to help anyhow do it more safely and effectively. This has been so successful that there are training programs like this nationwide, and recently they've gone international.As construction professionals, you have knowledge and equipment that can be especially useful for urban search and rescue.-- J.S.
*Stephen, Ditto what Andy said ! I will now have to figure out how to edit this whole subject ( Lost digits etc.) to poster size, so that it can become a permanent part of my safety bulletin board area ! Maybe taunton should market it ?