Mack The Knife

It is a curious phenomenon, oft observed in buses, that one waits for ages, then 3 come along at once.

And so it is sometimes in the ED...

While we get our fair share of trauma, we don't see much knife crime, and almost no gun crime. This last weekend, we got all our knife wounds at once. It's always slightly concerning when two fellas pitch up in short order, with similar sounding wounds. Not only does it raise concern that the Department might struggle to cope, but furthermore, that the two might have wounded each other - in which case, bedding them down next to each other in Resus is ill advised.

In this case, while I suspect the two wounds might have been related, they certainly didn't seem to have been inflicted mano y mano.

Number one had what I think of as the disemboweling cut - a transverse cut across the abdomen, running from east to west. His body habitus probably saved him from having to hold his guts in, but he'd been given a few other wounds for his trouble, and still won a trip to theatre to repair the damage.

Number two just had the one wound, but a good, solid stab. Providence decreed that his wound was right sided, and that he be attended by one of the pre-hospital guys with military experience. CT showed us the depth of the wound, and how lucky he was to have missed all the relevant clockwork. It's hard to convince someone with a new six inch air vent in their chest and belly that they've had a lucky escape, but he could have been a lot worse off.

Number three was one of our regulars, and the wound self inflicted and, apparently, less serious. It is a raw deal when you inflict major trauma on yourself as a cry for help, and arrive to find your wound is, at best, number three on the list of knife wounds waiting for a surgeon.

As far as I know, both the patients with wounds inflicted upon them did alright; i can't help but wonder how things might have been different if either, or worse both, wounds had been an inch or two transposed...