Case Study - Eaten by the Boat!-Video: Eaten by the Boat!

Video Transcription

Video Summary

Trident Hospital in Charleston presented a remarkable trauma case: a 24-year-old man severely injured by a boat propeller, with massive hemorrhage, GCS 3, and no initial blood pressure. The talk emphasized how survival depended on excellent pre-hospital coordination, rapid dispatch, tourniquet use, blood transfusion in transit, and strong communication among EMS, sheriff’s deputies, flight crew, and the trauma center.<br /><br />After rescue from the water, the patient was transported to Trident, where he required massive resuscitation, delayed CT due to instability, and immediate multidisciplinary surgery involving trauma, vascular, and orthopedic teams. Despite attempts at limb salvage, he ultimately required amputation. His course was complicated by hemorrhagic shock, rhabdomyolysis, liver injury, cardiac strain, and severe metabolic derangements.<br /><br />The presenters used the case to review mangled extremity management and the “diamond of death”: hypothermia, acidosis, coagulopathy, and hypocalcemia. Key lessons included stopping bleeding first, using tourniquets early, minimizing crystalloid, giving whole blood or balanced transfusion, warming the patient, administering TXA early, replacing calcium, and activating massive transfusion protocols without delay. The overall message: life-saving trauma care begins before hospital arrival, and communication and teamwork can determine survival.

Keywords

trauma

boat propeller injury

hemorrhagic shock

tourniquet

massive transfusion

mangled extremity

pre-hospital coordination

amputation