Amputation Surgeons, What Was Your Worst "Oh Crap" Moment?

surgeons who work with amputating limbs what was your worst off moment have a few stories one called to the ed to evaluate a table saw injury to arm found a mid-forearm amputation and ended up reattaching it two early in my training got a consult for a cyclist who was blindsided by a pickup truck and his entire leg was completely mangled ended up dying from massive muscle death and kidney failure three one of the worst cases was a patient with really bad sepsis from an infection all the blood vessels in your extremities constrict so amputating fingers isn't all that common but this was catastrophic as we ultimately had to amputate all four limbs information has been changed from previous post to protect identities surgery resident here the ofric moment doesn't really happen in the ore but can happen after one consideration is always at what level do you need to amputate the toe a transmetatarsal bka or aka below or above knee amputation if you decide too much some sicker or more elderly patients may never regain mobility again if you choose too little the disease process infection or ischemia might not be controlled or won't heal and you end up going back for more the realization you have to go back for more is the moment the 24 hours after a tough case are the worst you're wondering did you nail it or did you miss something somehow this isn't 100 on point but i think close enough and i think interesting i'm now a head and neck surgeon but during my trauma rotation as an intern we had an extremely inebriated guy come in who'd been hit by a car just outside of the party he'd been at and suffered a traumatic amputation the accident knocked his leg off at the knee so he's wheeled into the trauma gurney on a bed and his leg is brought into the same room literally in a bucket of ice the guy was super combative trying to push us around and at one point literally yelled frick off let me walk it off by my calculations he would have made it one step two tops made it one step two hops i remove a lot of eyes when training i had a nasty one that i just couldn't grip with forceps while i was making the main cut in the optic nerve i had to resort to gripping it with my fingers as you are imagining i made the cut it shot through my fingers like a grape hit me in the chest rolled down my gown bounced off my foot and rolled about 10 feet on the floor leaving a bloody snail trail it was a lunch break change so about 10 people were in the room switching over i headed upstairs when i was done to join my preceptor in another case he sees me walking sees a bloody spot on my shoe cover and asks you didn't drop they i did you my head just sank i remove a lot of eyes with a let off like that god dang agreed with the surgeon above that our training is so long detailed that we don't have these moments frequently however in residency i was doing a hemapelvictomy essentially a removal of half of a patient's pelvis with or without removal of that leg with my attending surgeon and we came to a crucial step after a few hours of dissection and planning we had made our cuts on the pelvis basically planning and mapping out the portion we would remove but the time came for us to complete the cuts by levering out the half of the pelvis with our hands which required a lot of force after the levering there was an audible crack expected but then the wound immediately filled with blood unexpected my training to that point told me to immediately pack the wound and hold pressure my attending looked at me and said keep holding pressure and then scrubbed out took off his gown and gloves and left the room i'm now standing there over this young patient holding pressure with all my might so that my arms are shaking i looked to anesthesia and his pa and asked what the heck was going on here i am single-handedly keeping this patient alive with no direction or immediate game plan about how to fix our problem this was my oh frick moment an eternity it seemed went by and my attending came back in scrubbed in and we then methodically isolated the large bleeding vessels and tied them off cauterized them afterwards i asked him what he was doing he said over the years he had learned if he had a rise in anxiety from something unexpected i guess his oh frick moments he would take a breather whether physically removing himself from the situation or not to refocus and psyche himself up to fix the issue this was one of my greatest learning moments of my career that's kind of terrifying but also really reassuring surgeons mostly know what the heck they are doing taking a breather in those moments is so smart not a surgeon but i work in a facility that helps with rehabilitation of amputees and getting them walking again i watch a resident go to stop a door from closing with his stump and it was like the world slowed down from the moment i saw him move his stump to stop it to the point of impact i was screaming oh frick that's gonna hurt so bad and it did he looked at me and just cried i pushed him back to his room in his wheelchair and he apologized profusely saying that it's just instinct cause he had a leg there for so long he ended up splitting the stitches back open and the infection that came after ended with him going from a midshin amputation to above the knee the next week he was a great guy he's walking and back to living his regular life again oh heck no i'll never again complain about my instinct that made me catch a falling cactus i work in the quality department for a large hospital system we had a doc take off the right foot instead of the left that was a lot of fun paperwork as well as a lawsuit wrong side surgeries are surprisingly more common than you think wrong side amputation however is thankfully more rare that's crazy when i had my acl repaired i had to verify to practically everyone who walked in the room which need was in the surgeon and i and i think maybe even the anesthesiologist both had to sign the correct leg in sharpie before they would even do the spinal block not a surgeon but a leg amputee i was reading the notes from my surgery and the doctor stripped the screws when trying to remove the titanium plate that was holding my leg together he had to call and back up you'd be surprised how easy it is for that to happen when screws have been in place for a long period of time the bone tends to grow into the grooves making stripping the screws quite easy we even have a broken screw set that we use to remove screws once they're stripped resident surgeon assisting on a below the knee amputation due to necrosis from diabetes leg was incredibly crusty with dead skin removed the leg handed it off to a tech to put into a box for disposal idaho spuds cardboard box lined in plastic attack trips on his booty almost fell but squeezed the leg so hard the inside popped out from the skin sock it flew across the floor leaving a slug-like trail of paluland slime as it skated we wretched we laughed we moved on skin sock i was first assisting honor emergent guillotine ankle disarticulation you basically just rip and cut the foot off from the leg and leave the bone sticking out i was providing traction on the intensely infected foot while the surgeon sliced through the remaining tendons holding it in place when the last one snapped i fell back holding on to the now independent foot squeezing a load of green pus out onto my chest it was just thankful it hit the gown and not my exposed neck i'm not a surgeon but i did rotate in surgery back in my med school days my first day on surgery rotation i was assigned to the trauma team this was at a level one trauma center in an inner city hospital in ny it just happened that on my first day all the residents were in a meeting so when the trauma surgeon needed an assistant she asked me to join her for an emergency above knee amputation of about infected leg wet gangrene and a very poorly controlled diabetic so my first day on surgery i'm in the or holding this man's infected leg while the surgeon soars it off after she's done she literally squeezes out pus from the thigh the odor was putrid it's one of those smells that lingers for days for the surgeon it was just another day but for me it was definitely an ufric moment the first surgery i saw as a nursing student was a toe removal poor patient had to have his big toe removed due to a diabetic ulcer that had gotten infected i was so afraid of the thought of getting nauseous with my first surgery i didn't eat breakfast that day the case started at noon i was wrapped in the sterile gown and mask hair cover shoe covers i was positioned by the circulating nurse in a spot where the great view but wouldn't get in the way the case started and the dock started cauterizing bleeding veins capillaries right off the bat i learned that cauterizing flesh smells a lot like searing steak my empty stomach and hungry brain didn't know the difference and i could hear my stomach growling at the smell i thought it would be just my embarrassment until the surgeon and nurse both looked at me they could hear it too i'm not sure what i said but i was glad my mask hit how i was struggling not to cry it was awkward until the doc took the severed toe and tossed it over the patient and into the formalin container he had great aim i feel your pain i was a nursing student watching a hysterectomy and the cauterization smelled like rotten mcdonald's to me next thing i knew i was on a stretcher with a nurse rocking my bent knees back and forth and rubbing my head i knew right then the ore wasn't for me as a med student i used a giggly saw to remove a dead leg from just above the knee from a man who was homeless and horribly diabetic when it came off the surgeon said here and handed it to me then he said take a picture it's your first one like someone was gonna have me hold it like a fish i caught he was joking but i was freaked out and dropped it on the floor such a weird moment in my training had a trauma case one time where the paramedics said a dog amputated a patient's foot we were expecting them to be blowing it out of proportion and got ready for just a severe bite nope we were wrong patient rolls in on the foot is almost completely off except a piece of skin holding it together turns out the dog must have been super p because it chomped right through or nurse here recently did a below the knee amputation the leg was severed and i was passing it off to the circulating nurse for specimen went to take a clamp off a large artery and my poor co-worker got a big spray of blood i felt terrible not related to amputation caesarean section but when i was a student midwife i managed to forget to attach the catheter back to the tubing when catheterizing and i managed to get urine into the theater nurse's eye i was not popular i had to explain to the patient why we had to take bloods after the baby was born as part of the potential contamination protocol she thought it was hilarious [Music] we had a trauma coming from a concrete factory i'm not sure about the exact details but a guy fell into some machine and his left leg got pretty messed up we went to the oh to wash it out and evaluate if he needed an amputation or not once we got it all cleaned up we saw it was pretty mangled and there was concrete encasing part of his leg so we start to do an above the knee amputate because there's concrete in his knee and distal femur as we're pushing the oscillating saw through the femur it hits more resistance usual and starts to make unusual sounds we had missed some concrete on the back of the guy's thigh and tried to sore through it almost everyone in the room the nurses anesthesia the students etc said oh frick at the same time we ended up having to go even higher up on fema i'm not sure whatever ended up happening later on prosthesis wise because we transferred the patient to the ortho service nurse in an emergency department accidentally amputated a toe that was rotting in a boot when i pulled it off the patient's foot but there were many frick said that evening does that count medical student future orthopedic surgeon on my vascular surgery rotation we had a gentleman who initially came in after a left tma transmetatarsal amputation where your toes are amputated that wasn't healing and becoming infected the next step after that was a bka baloney amputation in an effort to both stop the infection from progressing higher up his leg and also be able to receive adequate blood flow to heal that surgery was executed well but unfortunately the day he was cleared to work with physical therapy he fell on the other right knee which created a hematoma that later became infected about a month later when i had transitioned from vascular to orthopedics we performed a salvage aka above knee amputation on that leg our gentleman went from being able to walk with difficulty to losing both legs in the span of about two months a surgeon but used to work in a nursing home and i was meeting a patient for the first time without reading their file as i entered the room i said wakey wakey let's jump out of bed and as i looked at him i said let's kick those covers off once i removed the blanket and saw he had no legs things got quite quick i've always told my patients to jump out of bed no matter the state of their limbs one guy with a straight face said i can't those bastards stole it he lost a leg in world war ii i grinned and he hopped out of bed he had a great sense of humor when i was a child my dad's favorite joke whenever i hurt myself and cried was to grab a meat cleaver from the kitchen hide it behind his back examine my injury closely prodding the sore spots with his finger and after 45 seconds of examination of the bruising say i'm sorry son we're going to have to amputate your insert leg foot limb hun come hold him down while i chop please and he'd whip out the cleaver and carefully line it up while six-year-old me would scream and try and squirm free and run away he'd then usually say when i hobbled away oh so it must not be that bad after all hun cancel that procedure turns out he can actually walk one time he did this and i caught him in the stomach with a little kick and he let out a little frick and almost dropped the cleaver so this reminded me of that thanks my dad did the same but only after he had checked i wasn't seriously hurt i used to make a scene so that was his way of teaching me not be such a crybaby not a surgeon but had a patient who was homeless and did not seek medical treatment for an ingrown hair that had became infected by the time the man was brought into the ed he had developed fernie's gangrene google at your own risk that required amputation of his testicles and debridement of his perineal area the smell was so rotten as the infection had gone on for so long that even most of the season door staff had to leave the room to vomit at one point only the surgeon and anesthesiologist were in the room they ended up removing everything from his shaft to his anus don't don't don't look at the pictures just be okay with googling the definition but not the pictures helped at a leprosy hospital in the mid-90s in calcutta two memories one a big bottle of surgical spirits fell off a table and exploded into fire during an amputation two the doctor spilt some of the general anesthetic when injecting a patient he continued with the amputation anyway the patient started to come round early so four of us had to prevent the patient from flailing around while the doctor finished sawing and then stitching [Music] this is a long story from a long time ago like 30 plus years so please bear this in mind i was working as a junior doctor in orthopedics andy we had a young guy on the ward who had come off a motorbike and suffered compound fractures of all four limbs compound fracture broken bone plus broken skin so a risk of infection etc his right leg was especially bad with the compound fracture of the femur thigh bone and compound fractures of the tibia and fibula shin bone because he came off into a ditch the cavity of the femur had soil gravel dead leaves etc in it and it took a lot of surgical toilet oh and he had also severed the sciatic nerve so to stabilize the femur six pins were put in three above the fracture and three below these were jones using an external fixator bar attached to the pins using a quick drying resin cement in the fullness of time it was apparent that the lower part of the leg below the fracture of femur had become non-viable and would have to come off we took the guide to theater and the first thing was to remove the resin from the fixator bar but it was so tough the surgeon i was only assisting could only chip a few small fragments off so he decided to simply snip through the pins which he did and off came the fixator bar then when he came to remove the pins he found he had snipped off the square heads leaving only the round part of the shaft so there was nothing for the removal chuck to grip undaunted he sent for a surgical crown drill bit a hollow drill bit which would go over the pin and drill out a small cuff of bone allowing the pin to be removed this worked fine for the first of the three pins but while the second pin was being removed we found the bit had bent so every time the drill was activated the patient and has leg shook like a leaf in the breeze then the head of the drill bit broke off and fell into the cavity of the femur we sent for another crown bit there wasn't one in the hospital so we had to send a taxi to the hospital up the road to get one when it came back we found it wasn't sterile so we had to wait for it to go through the sterilization cycle finally we got the pins out then we tried to get the broke drill bit out but we couldn't find it the leg finally came off the operation concluded and the patient returned to the ward it took five hours and all when we expected one two hours i had a right or keyoctomy for cancer i looked over my notes for my first ct scan and they said that my left testicle was missing i politely asked my oncologist to follow up on that one i am not a vascular surgeon i am another type but when i was an intern on my vascular surgery rotation i was participating in a bka below the knee amputation and stabbed the attending surgeon with a rake a surgical instrument she was okay didn't breach the skin surgeon that has done these more than a few times i think one of the worst was i had a patient who had gangrene nearly up to both his knee it was so painful he was begging us to cut off both his legs until he was happier without them surgeon here we go through extensive training so those moments don't happen the only time i've even had that thought on the or is in reaction to how far a patient has let the disease process go before seeking treatment usually an infection i had an ingrown toenail that i'll let go far enough that two doctors actually yelled holy crap when they saw it i now go to the doctor immediately when i need to there was a guy who got in a motorcycle accident and was in excruciating pain in his left leg but we had no idea why because there was minor bruising and didn't seem to be any breaks so we called in another trauma surgeon to take a look at him the surgeon looked at him just as confused as we were so he decided to put him under sedation so he could figure it out after a while of looking he picked up the guy's leg and turned it 360 degrees suddenly blood started gushing from the poor guy's hip joint turns out his leg was turned all the way around to hide the break i've read like 30 of these things and this is the one that finally got me off to read the rest help not me but my aunt was a surgery nurse for 20 years first time she was in an ore the surgeon throw her the foot he just amputated she caught it and everything went as normal he asked her to be on the team whenever he was operating after that i was a surgical tech in the early 1990s we were doing an aka on somebody with a gangrenous foot we cut through the tissue and the giggly sore broke when we were one stroke four of the way through the femur but the hospital didn't have another all of the ortho sores were in use the doctor made me get the guy's leg under my arm jump up in the air come down with all my weight and snap the femur at the point where we started sawing it took two three tries but then snapped and splinted we used a rasp to smooth the bone i was left holding the gangrenous lower leg it was big so i tried to bend it at the knee to get it in the specimen bag at which point a bunch of blood squirted out of the leg and all over the face of the circulating nurse not my finest day i was 18 and being paid minimum wage this story was not a tragedy until the very last sentence there's an amputation that set the record for both the fastest amputation at the time and most deaths still the record holder the surgeon performed the surgery so fast he took off his asses and fingers in the same cut both the patient and the assistant died of infections a gentleman viewing the surgery died of freight whilst watching a heart attack in modern day one would assume why did he try to do it so quickly without anaesthetic surgeons tried to minimize pain by speed and getting the patient crap faced on booze pre-operation so the surgery had a 300 death rate but technically speaking it was a success i read this like the surgeons work alongside disembodied limbs for assistance like thing from adam's family or something not a doctor but a good friend of mine who's currently doing their residencies told me a fantastic story of when they were practicing leg amputations on a cadaver a reasonable size chunk of flesh flew off and went right into their mouth this was followed by immediate vomiting and a weak strain of listerine smoothies when asked about the taste and texture they described it as salmon sushi with formaldehyde i just hope they haven't developed a taste for human flesh but just in case i'll be on guard i nearly vomited reading that so perhaps this makes me a horrible human being but most of this has me morbidly fascinated with every single story and wishing i could read transcripts or something to learn more about the medical decisions in crazy cases like this circtech assistant here with two amputation stories one as a very new tech i was in my first bka below the knee amp the surgeon used the saw to cast the through the bones and then use the amputation knife old school aka philip knife once the remaining tissue was removed the surgeon handed me the specimen when grabbing the leg from the dock i foolishly grabbed squeezed the calf with the amputated portion quite close to my face not all of the vessels on that side were clip tied off so when i squeezed a bunch of blood that had been in the dead leg squirted all over my face it was crazily disgusting and nauseating my thought was wtf just happened lesson learned two probably the craziest amputation story of all time that most have never heard a hospital in bellagham la peace health was probably trying to save money by discarding biohazardous materials in the regular trash disposing of red bag bio trash is super expensive and is usually burned or radiated how this was discovered is the crazy part a lady went outside to see what the heck her dog was chewing on upon further inspection she saw that her dog was chewing on what appeared to be a human leg cops are called people freaking out thinking it's part of a murdered victim's body investigations ensue turns out it was a leg that had been amputated the hospital had been throwing tissue limbs etc into the general trash the dog smelled it at the dump site and drug it home to snack on in familiar surroundings i believe there were big lawsuits fines i think it happened 15 or so years ago i was told the story by the nurse that was your manager when it happened oh frick if you are new to the 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Id: 4tz2KcdNIbs

Length: 25min 36sec (1536 seconds)

Published: Thu Apr 29 2021