May 6, 2016

Interviewer: Common ways that people cut themselves that lands them in the ER. That's next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health Care. What are some of the ways that you see that people come into the ER that they've cut themselves that lands them in the ER? The whole point of this is to maybe make us all a little bit aware.

Dr. Madsen: Sure.

Interviewer: When we're doing one of these things that, you know, this is a common way that somebody could cut themselves.

Dr. Madsen: Yeah, it is, and we do see lots of lacerations. Probably when you think of the ER, you think of going there because you were cut at some point and maybe had to have stitches. One of the common ways I often see people cutting themselves is cooking. This is something where I oftentimes see people who work in restaurants, who cook on a regular basis and are slicing and cutting things up and they'll catch a finger.

That's the most common site. They'll sometimes cut off the end of the finger, just the tip of it, not through the bone but slice off a piece there or cut down through the fingernail and then it seems to stop once it hits the bone. That's not an uncommon thing I see just from rapid cutting and just getting their finger in the wrong spot and getting that knife right through it.

Interviewer: Yeah, restaurant workers. What about just regular people? Not quite as much?

Dr. Madsen: Oh, sure. We see it with regular people, too.

Interviewer: Yeah, sure.

Dr. Madsen: But I guess for me it's always a surprise when you see the restaurant worker where they're doing this all the time and then they cut themselves and they always say they feel stupid, but it happens quite often.

Interviewer: Okay, so kitchen accidents. Watch those kitchen knives.

Dr. Madsen: For sure.

Interviewer: Be careful.

Dr. Madsen: Watch the kitchen knives and watch your fingers when they're near the kitchen knives.

Interviewer: Because that's the common kitchen cut, is a bit of finger.

Dr. Madsen: Exactly.

Interviewer: More so than a [makes cutting noise].

Dr. Madsen: Oh, yeah, for sure. I usually don't see someone who sliced down through their hand. It's almost always on the finger.

Interviewer: Okay. All right, what's the second kind of most common cut that you might see?

Dr. Madsen: The next common cut I see is someone who falls. They either land on their elbow and that will split the elbow open causing a laceration there, or they hit their knee and slice their knee open, or sometimes they'll fall and hit their head.

These head injuries, when it hits the scalp, that's where you really see a lot of bleeding. A lot of times they'll just come in with all sorts of bandages or holding towels on their head and just saying, "I must have a huge laceration on my scalp because it's bleeding like crazy." We'll pull these towels off and it's maybe only an inch long.

Interviewer: Oh, no.

Dr. Madsen: But scalp lacerations bleed like crazy. That's the bottom line. That is probably the next most common thing I see.

Interviewer: So they look much worse than they really are?

Dr. Madsen: They really do.

Interviewer: Generally?

Dr. Madsen: I think they really scare people and it's something you've got to go to the ER for typically, or maybe an urgent care because you do have to have it repaired, but a lot of times it looks much worse than it actually is.

Interviewer: All right. So I guess I didn't even consider a cut caused by blunt trauma.

Dr. Madsen: Sure.

Interviewer: That's interesting.

Dr. Madsen: Not an uncommon thing.

Interviewer: What are some other common ways that you see people with cuts?

Dr. Madsen: So another common thing we see is power tools. I've got to throw this one in here because probably the biggest surprise for me when I started working in the ER was all of the table saw injuries I saw. It's funny because at the time I had this old table saw in my garage. I'm not an experienced woodworker, but I thought I'm going to pull that saw to make some stuff with it.

Within the first month I probably saw four people who came in who had had their fingers amputated, cut off, from table saws. So I immediately got rid of the table saw. These were experienced carpenters and woodworkers that just said, "You know, it just happened." As they were pushing the wood through this table saw it just jumped or whatever, it hit a knot and their finger jumped forward, just cut right through the finger. So household equipment, power tools, table saw injuries, we do see a lot of those.

Interviewer: Watch those sorts of things. You've got experienced people that are cutting their fingers. Is there anything you can do to avoid that?

Dr. Madsen: Well, there are certain techniques you can use. I know there actually are some power tools and table saws that, I don't know how they're designed to do it, but somehow it's able to sense if that saw hits flesh. I don't know how it knows this. It's pretty remarkable.

Interviewer: I know, I took a woodworking class and the guy said you could take a hot dog and go to run it through this blade and it would stop it without cutting that hot dog.

Dr. Madsen: Yeah, it's amazing, but apparently you don't want to try the hot dog because if you do that, the way the mechanism works it just throws some steel right up into the blade and pretty much destroys the tool. Apparently, that's an option. I think there are other techniques where you're just not getting your hand close to . . . like, using a piece of wood or something to push that wood through rather than getting your hands right in there.

Interviewer: So three ways that people tend to cut themselves. Is there kind of a fourth category that you could lump in, two or three of the more minor ways?

Dr. Madsen: Yeah there are always knives. People who have pocket knives or maybe something where they're using their knife or some kind of tool to try and use it in a way maybe it shouldn't be used. Something slips or . . . you know I've got to tell you a personal story. I once made the mistake of trying to separate several frozen hamburgers using a butter knife. The butter knife slipped and went right into my hand.

Interviewer: A butter knife?

Dr. Madsen: Yeah, a butter knife. It was not good. I threw a little suture in that and tried to sew it up myself. It actually worked okay, but that's the kind of stuff we see, too. People with different household items, maybe screwdrivers, things like that, trying to use them in certain ways and something slips and cuts themselves.

Interviewer: Using them in a way that they weren't intended.

Dr. Madsen: Exactly.

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