The Deadest Person
It was the end of my shift and I was just leaving Slidell Memorial Hospital in Louisiana when I was called back. The paramedics had just alerted the Emergency Department that they were on the way with a severely injured trauma victim and my help was needed.
The patient was about thirty-years-old and was not wearing a helmet when he crashed his motorcycle into a car at high speed. He was thrown under another car, which ran over him. A voluntary ambulance crew picked him up and rushed him to our emergency department, performing CPR.
Since the patient was not breathing, I was assigned to intubate him by placing a tube into his windpipe so we could ventilate his lungs with oxygen. As other members of the team quickly performed their assigned duties, I easily passed the tube, secured it in place and then started to blow oxygen down the tube. What happened then caused everyone to stop what they were doing. With each push of oxygen down the tube, he started to puff up. His neck expanded and air bubbled out of a cut near his eye. His abdomen started to expand, then his scrotum. Each time I pumped in air, his scrotum puffed up a bit more until it was the size of a grapefruit. When I pinched the enlarging scrotum, air was forced out of a large cut over his hip. He was pronounced dead.
An autopsy done the next day showed multiple fractures of his extremities and spine. In addition, he had at least four things that would have killed him: His head was completely dislocated from his upper spine. His left lung was completely ripped off with extensive damage to all the other organs in his chest. There was a huge hole in his diaphragm, which separates the chest cavity from the abdomen. His liver was completely demolished. His pelvis was severely crushed. All of this explained why he had puffed up as we blew oxygen into his wind pipe. The oxygen went down the windpipe and into his chest cavity. It then passed through the hole in his diaphragm into his abdomen. The crushed pelvis allowed the air to continue down into the scrotum and out the hole over his hip.
This was the deadest person I have ever taken care of.
Do you usually get autopsy reports on ER patients who die, or was this an unusual case? As sad as it might be, I can see how it could be really instructive to get autopsy reports on patients you have treated or diagnosed–as in this case.