non-HIPPA related med report

1/23/2010
26 y/o male c/o finger laceration secondary to a speed ice climbing competition event:
The patient was able to rip the protective leather finger off the third digit of the glove and still create a full thickness laceration. The finger of the glove was still on the ice pick what the subject was lowered to the ground.
Mild hemorrhage was immediately controlled by the patient and then myself since I was present and witnessed the event (have it on video).
The patient was prepped and draped in a non-sterile fashion in a Swiss climbing bar with a dirt floor in Saas-Fee only 20 paces from the ice climbing event. No local anesthesia was used, but the patient enjoyed general anesthesia effect from the multiple alcoholic beverages that were given him by the locals who insisted he partake in the festivities at the time of being provided acute medical care.
The patient was taken to a Red Bull table in the bar where the best light was. Hemostatis was achieved by using a finger tourniquet. Irrigation of the would using the tap water out of my Camelback in my Avalung backpack was the only water available. Power irrigation was achieved using a 10cc spring loaded syringe and 18ga angiocather from my trauma kit in my backpack. My First Assist, Malcolm Kent (another athlete) was able to maintain control of the water supply.
The 1cm x 0.5 cm 90 degree angular full thickness laceration to the 3rd digit on the medial side of the right hand is located between the DID and PIP. Exploration showed no deeper structure involvement and the patient had good motor and sensory distally. No tendinous involvement.



Multiple photographs from by-standers were being taken but the flashes did not interrupt or hinder care. Red Bull and Vodka and Rum and Coke drinks had to be removed from the table several times throughout the procedure.
No gloves were able to be used and no drapes were available. So, I used sterile 4x4 gauze as a drape and sprayed my fingers down with the water irrigation solution.
5.0 Prolene was used to place three interrupted sutures and close the wound. The tourniquet was released and a sterile bandage was placed over the wound site. The last suture was difficult to place since the bar lowered the lights and the band started to play rock and roll with the speakers being right next to the table.
No splint was available besides bar straws, so I just advised the patient to try and keep the finger straight and refrain from flexing.
The crowd cheered when we were finished and the Americans stayed at the party.
I will be following the patient since he is my roommate and I’ll be skiing with him for the next 3 days and ice climbing with him for the next two weeks at the World Competition circuit throughout Europe. I will make sure that the stitches stay in longer if he is placing more force on them than necessary while ice climbing/skiing.

1/26/2010
Day three after the incident, the patient shows me his wound and it appears to be weeping with subsequent sticking to the bandage. I placed a small amount of Neosporin ointment near the wound and re-bandaged with an American Flex-fabric Band-Aid. The wound looks good and there’s no sign of infection.
Will consider taking out the stitches after the Rabenstien Ice Fight competition in northern Italy.

NOW THAT's what friends are for !