Catching a bus shouldn't be life-threatening. But for one 23-year-old woman, running for the bus could have cost her everything.
After rushing to hop on board, she fell unconscious, leaving her arm outstretched beyond the door. Not knowing this, the driver closed the door and drove to the next stop, about two-tenths of a mile away.
The passenger was shocked awake by her AICD, which she wore because of a history of hypertrophic obstructive cardiomyopathy. As she regained consciousness, she realised her forearm was still outside of the bus.
In the emergency department, the doctors quickly understood the seriousness of her injuries: open fractures, multiple lacerations, and soft tissue injuries. A potential major complication of her surgery was compartment syndrome. The medical team knew she had an AICD in place but they didn't have access to any of her cardiology notes. Her luck turned for the better when she was treated by Anaesthesiologist Jeff Gonzales, MD, MA. After taking the patient's history and conducting a physical examination, the team discussed the risks, benefits, and options for her anaesthetic plan. Considering her cardiac history, the urgency of surgery and the potential risks of surgical repair, Dr. Gonzales settled on a peripheral nerve block. Relying on his years of experience and a point-of-care ultrasound system, Dr. Gonzales carefully guided the needle to successfully achieve a complete nerve block of the arm. The surgery lasted two hours. Forty-five minutes into recovery, the patient could move her arm. A few hours later, all feeling in her arm returned. And in the time since that short--but eventful--bus ride, she's made a full recovery.
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