400-Pound Patient Impales Himself Twice Falling on Magazine Rack

Engine 1, an ALS engine company staffed with one paramedic and two EMTs, is dispatched to assist police with a welfare check. On arrival, the crew finds a small, one-story house with the doors locked. After knocking on the door, a male voice is heard yelling for help. The door is immediately forced open and the crew finds a conscious obese male, lying supine on the floor, impaled by two wooden dowels of a magazine rack. The dowels are penetrating the posterior right buttock and continue through to his lower abdomen and pelvis. The officer radios dispatch and requests Truck 1 and Rescue 1 be dispatched emergent to the scene because additional resources and manpower are needed. The extra crews arrive on scene simultaneously. The patient is a 70-year-old male, 6-foot 6-inches, weighing approximately 400 pounds. He's lying supine on the floor with both legs bent at the knees and folded underneath him, his skin is noted to be pale and dry, and his right lower leg presents with cyanosis, is cool to the touch, and distal pulses and sensation are absent. The patient denies any complaints other than "wanting to get up off the floor" and says he was ambulating when he slipped on a magazine and fell backward onto the magazine rack; he believes he's been down between 12 and 24 hours. Examination reveals a wooden magazine rack approximately two feet in length with 12"-long wooden dowels sticking up vertically at 3–4" intervals. Two of the dowels have impaled the pati...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Case of the Month Patient Assessment Special Patients Trauma Special Challenges Bleeding Patient Care Burns & Soft Tissue Trauma Special Topics Source Type: news