Tonight’s ED awards

Two are given tonight, the luckiest in a bad situation (LABS), and the dumbest aquatic act this summer (DAAtS).

LABS: adult male, who was getting ‘on his face’ at gunpoint, when the criminal actually shot him. An in and out wound of the skin of the shoulder (just like in the movies, no muscle involved), and a bullet wound between his eyes from the ricochet of the round off the ground. I took the flattened little chunk of metal out of his forehead and handed it to the nice officer taking pictures. The victim/patient had no other injuries and went home. I think he got tired of me telling him how lucky he was.

DAAtS: young and dumb, several times the legal alcohol limit, on a jet ski at 1 AM: what could possibly go wrong? Well, the dock is hard to see, it seems, and he hit it at speed.

He had the proverbial sucking chest wound, and had his life saved by some EMT’s and this cool thing, which I didn’t know existed (it’s an adhesive dressing and a Heimlich valve in one combination; terrific gadget). I could see his lung under the dressing, and that’s bad, because that means some chest wall is missing. It’s probably still on the dock. He’ll most likely be fine, but he’s going to hurt for a few days.

I have the best job in the world.

cross posted on The Lingual Nerve


  1. The thing is technically called an Asherman Chest Seal (ACS). It was developed by an Ex-Navy Seal I believe. We carry them and they have become pretty much standard equipment in EMS over the last few years.

    It’s easier than a rubber glove finger tip. You just perform a routine Needle Decompression and put the Seal over the Cath, or in this case over the wound itself.

    Much neater and aseptic than Vaseline gauze on sucking chest wounds, but I still prefer a water seal on Needle Decompressions.

  2. I don’t get it.

  3. hmm, beats the “use your ID card to cover the sucking chest wound” crap I learned in “Med Helper” school all those years ago.

  4. “Consistency requires you to be as ignorant today as you were a year ago.”

    –Bernard Berenson (1865-1959)

    If you are going to quote published writers, kindly give credit. (Similar to needless consistency being the hobgoblin of small minds, to paraphrase Emerson, although I can’t see
    why either would apply to your post either.)

  5. I suppose that explains his sig line, but I still don’t get how that applies. Perhaps he only knows one quote, and it fits all posts?