It’s fireworks season again. Let’s be careful out there
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@George-K said in It’s fireworks season again. Let’s be careful out there:
Actually, these are pretty easy to treat: cut off everything that's dead, sew it up, and refer to physical therapy/rehab.
I would have somehow expected that these things would be treated in 20h long sessions in the OR, in which some poor hand surgeon would try to piece everything together again.
@Klaus said in It’s fireworks season again. Let’s be careful out there:
@George-K said in It’s fireworks season again. Let’s be careful out there:
Actually, these are pretty easy to treat: cut off everything that's dead, sew it up, and refer to physical therapy/rehab.
I would have somehow expected that these things would be treated in 20h long sessions in the OR, in which some poor hand surgeon would try to piece everything together again.
Yes. The hand surgeons I worked with (now, granted this was a LONG time ago) always said that as far as re-implantation goes, it's never a good idea to re-implant one digit, unless it's the thumb. Furthermore, the viability of tissues with these injuries is marginal, at best. The rehabilitation is long, arduous and painful - frequently with minimal gain of function. Often, you're better off with an amputation and learning how to live with that.
Re-implants were, yeah, a long AF procedure. Usually 12-20 hours.
The major problems from an anesthetic management standpoint included appropriate hydration and keeping the patient warm (more difficult back then than now - we used all kinds of tricks back then).
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@Klaus said in It’s fireworks season again. Let’s be careful out there:
@George-K said in It’s fireworks season again. Let’s be careful out there:
Actually, these are pretty easy to treat: cut off everything that's dead, sew it up, and refer to physical therapy/rehab.
I would have somehow expected that these things would be treated in 20h long sessions in the OR, in which some poor hand surgeon would try to piece everything together again.
Yes. The hand surgeons I worked with (now, granted this was a LONG time ago) always said that as far as re-implantation goes, it's never a good idea to re-implant one digit, unless it's the thumb. Furthermore, the viability of tissues with these injuries is marginal, at best. The rehabilitation is long, arduous and painful - frequently with minimal gain of function. Often, you're better off with an amputation and learning how to live with that.
Re-implants were, yeah, a long AF procedure. Usually 12-20 hours.
The major problems from an anesthetic management standpoint included appropriate hydration and keeping the patient warm (more difficult back then than now - we used all kinds of tricks back then).
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@George-K said in It’s fireworks season again. Let’s be careful out there:
we used all kinds of tricks back then.
Turning up the heating and using a blanket?
@Klaus said in It’s fireworks season again. Let’s be careful out there:
Turning up the heating and using a blanket?
Surgeons complained about the heat, and forced-air blankets were not available.
One of the best things we could do, in the day, is to have the patient re-breathe as much of their exhaled gasses as possible (after removing CO2 of course). You lose a LOT of body warmth in the air you exhale. If you can prevent that, it went far to prevent hypothermia. In fact, after about 6-8 hours, patients would actually come to PACU warmer than normal!
Heated pads under the patient were mostly ineffective in preventing heat loss.
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(https://nypost.com/2022/07/05/11-year-old-camrynn-mcmichael-killed-in-fireworks-accident/)
I hate how the headline says it was a "freak" accident. That doesn't make sense.
(Still, quite a tragedy.)
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Yeah, saw that on TV last night.
"Where should we put the box of fireworks?"
"How about directly under the gas tank?"
"Great idea! They'll be in the shade!"
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Yeah, saw that on TV last night.
"Where should we put the box of fireworks?"
"How about directly under the gas tank?"
"Great idea! They'll be in the shade!"
@Mik said in It’s fireworks season again. Let’s be careful out there:
Yeah, saw that on TV last night.
"Where should we put the box of fireworks?"
"How about directly under the gas tank?"
"Great idea! They'll be in the shade!"
That needs to be set to the 1812 Overture.
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@Mik said in It’s fireworks season again. Let’s be careful out there:
Yeah, saw that on TV last night.
"Where should we put the box of fireworks?"
"How about directly under the gas tank?"
"Great idea! They'll be in the shade!"
That needs to be set to the 1812 Overture.
@Ivorythumper said in It’s fireworks season again. Let’s be careful out there:
That needs to be set to the 1812 Overture.
Do y'all remember Jeff Foxworthy? "If you store your box of fireworks under the gas tank to keep them out of the sun, you might be a redneck."
