From the Frontlines: AugustSep 24, 2013
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Scot: It's time for another edition of From the Front Lines with Dr. Troy Madsen. Now as an Emergency Room Doctor, you have your finger on the front line of our health concerns. Likely you're going to see it before anybody else, so what are you seeing right now that we should know about?
Dr. Troy Madsen: Well, the big thing we're seeing right now, surprisingly, just this last month, I've see a lot of injuries related to livestock.
Scot: What? Like cows and goats and chickens?
Dr. Troy Madsen: Cows and bulls and farm animals. Exactly.
Scot: Do you have any idea why that would be?
Dr. Troy Madsen: Well, I've tried to tie this together and say, what is going on? And I think it's a lot of county fairs. A lot of communities . . .
Scot: Oh, sure.
Dr. Troy Madsen: . . . have their county fairs, usually in August and the Utah State Fair is coming up in a couple weeks in September. But at lot of these county fairs we're seeing a lot of bull riding injuries, horse related injuries, and in some cases some very serious injuries coming in.
Scot: So like rodeo stuff mainly or stuff that the average non-rodeo person would have to worry about do you think?
Dr. Troy Madsen: Mostly rodeo stuff.
Dr. Troy Madsen: But I think if you're around livestock, anything like that at the fair, you have to be careful. But the primary injuries I've seen have been in bull riders where they're coming down very hard on the bull, sometimes causing pelvic fractures, very serious back injuries, sometimes being tossed and causing some issues there as well. But surprisingly a large number of those lately.
Scot: Actually that brings up a good point. If you have small kids, a lot of times you go into the animal barn. Watch the small kids. They might wander up behind an animal.
Dr. Troy Madsen: I think the take home point for those of us who don't ride bulls on a regular basis would be just be careful. You know, when your kids, if you're at the Utah State Fair, have a great time there, but certainly coming up behind animals, behind a horse, you might startle them, they might kick you. That could lead to serious injuries. Just always be aware of that potential. If you're riding horses, wear a helmet. It's surprising, looking at our numbers for . . .
Dr. Troy Madsen: . . . trauma, when we actually looked at what causes trauma that comes in our ER, a number five on that list was horses, falling from horses, getting kicked. So be aware. It does happen quite a bit.
Scot: And a helmet could help prevent a lot of what you see.
Dr. Troy Madsen: Exactly.
Scot: Okay. What about ATV injuries. I know in the beginning of the summer you get a lot of those . . .
Dr. Troy Madsen: Yeah.
Scot: . . . because people can't wait to get on their ATV's. What about the end of summer?
Dr. Troy Madsen: Yeah. We seem to have seen a spike lately in ATV injuries and the best explanation I can come up with is people know the summer is kind of winding down, they're getting back into school, some of the kids are getting back to school, so they're getting out with the family. One of the big concerns is roll-over injuries and especially with young children, if an ATV rolls on a young child that can be just an absolutely devastating injury.
Scot: Okay. As an Emergency Room Doctor, ATV's, helmets, is there anything else you'd want an ATV rider to know?
Dr. Troy Madsen: Be careful with young kids. I mean I think that's the biggest thing for me. I'd just hate to see these injuries to children. But be very careful. Be aware they can easily fall off the back of an ATV, the roll-over injuries are huge and just devastating in those situations.
Scot: What's coming up from the frontlines? What do you expect? Because I'd imagine you can almost predict what season it is by what you're seeing.
Dr. Troy Madsen: Yeah. It is funny. You work long enough and you just kind of see certain patterns. The one pattern that is really surprising, but has held up over many years, is table saw season. Once it gets into September, we start seeing all sorts of patients coming in, either directly to the ER, transferred from other hospitals, for amputated fingers. And I figure what happens is we all put off these home projects all summer. We're enjoying the summer and then it gets to be fall, and we're saying, "I've got to get this done before winter comes." So you pull out the table saw. You start working with it. Something happens and you cut off a finger. So just be careful. Lots of table saw injuries this time of year.
Scot: Let's talk about that quickly. If that happens, what should I do? Do I put my finger in a cold cloth? What?
Dr. Troy Madsen: So if you get your finger cut off, let's hope you don't, but if it does happen, make sure you find the finger, call 911, get to the ER. Take that finger and put it on ice. Not directly on ice. You can put it in towel or a rag, something like that, in ice. If it's directly on ice that can cause frost burn injury and kill the finger itself. But if you can get to the ER quickly enough, we can often times get our hand surgeons there and get that re-implanted and back in place, and you can have a fully functioning finger.
Scot: What about bleeding?
Dr. Troy Madsen: So bleeding, hold pressure. That's the number one thing. As you're bleeding out from the site where the finger was located and is now gone, hold pressure there. Stop the bleeding. Don't apply a tourniquet. Don't take a tourniquet and tie it on your arm because that's just going to cut off all the blood flow and cause more damage. But pressure is the big thing.
Scot: And call 911 and have an ambulance come, don't drive yourself.
Dr. Troy Madsen: Exactly. Time is of the essence. Think of this as you would a stroke. You think of a stroke, like, time is brain. In this kind of situation time is tissue. Time is your finger, potentially getting that finger back on.
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