#31 Doesn’t Make Any Sense How She Survived
I was working as a helicopter retrieval doctor in Australia last year. Called at 2am to a car crash in the middle of nowhere. Patient was 150 kg (330lbs.) and 5-feet tall. So drunk you could smell the alcohol in her blood. Had been ejected from the front passenger seat of a car through the front windscreen. Wearing no seatbelt.
She had lain undiscovered for three hours on the side of the road. The temperature that night was 2 degrees centigrade. Her entire right scalp had been degloved. Blood pressure and oxygen saturation were unrecordable at all times on transfer due to shock, hypothermia, and body habitus. Carotid pulse only. GCS 3 (completely unconscious).
Due to her ENORMOUS obesity any movement of her head from the position she happened to land in obstructed her airway. If she had landed in any other position she would have had no way to breathe and died. Two hour flight from nearest trauma center. Unable to intubate her without drugs due to muscle tone. Scariest RSI of my life.
Gave her drugs to paralyze then intubate in the middle of a paddock, on ambulance stretcher, under lights, with patient placed in RAMP position. With best rewarming we could do in the helicopter core temperature was 29 centigrade on arrival in ER. We didn’t carry blood on the helicopter at that time. Survived and discharged neurologically intact.
Credit: milimbar
