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Thu Oct 19 22:44:19 BST 2006

Most of this was reported on The Early Show this morning along with the
patients name and hometown and film of him being wheeled into the
hospital, followed by an interview with the 3 physicians that worked on
him.
REM 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of p.bjorn
Sent: Thursday, October 19, 2006 10:52 AM
To: M2darwin at aol.com
Cc: trauma-list at trauma.org
Subject: Re: ccml Stingray again!

This is a rather intimate level of detail.  Did the patient give consent
for it to be broadcast over the internet?
  ----- Original Message -----
  From: M2darwin at aol.com
  To: crippen+ at pitt.edu ; ccm-l at ccm-l.org
  Sent: Thursday, October 19, 2006 3:42 PM
  Subject: ccml Stingray again!

  An 82 year old Florida man was impaled by a stingray barb from a
stingray that jumped into the boat he was in and stung him. The barb
entered the inferior wall of the LV just below the tricuspid valve and
was then drawn through the heart and through the wall of the RV. The
ratchet nature of the barbs reportedly moved the barb through the heart
due to ventricular contractions and chest wall motion from breathing.
The barb was not acutely removed, and the patient was transferred to a
Level One trauma center in Broward county, FL. He was taken to theater,
put on CPB, and the barb was removed by pulling it through the heart
after decompressing the pericardial tamponade which had developed. The
ventricular and septal perforations were repaired with purse string
sutures. The echo is truly amazing!

  The patient is stable and doing well following surgery. Of course, he
faces the usual post-op risks of DVTs, sepsis, and the like. As the
surgeon emphasized, a big difference between this gentleman and Steve
Irwin was that first responders did not remove the barb. Luckily, it had
broken off inside the chest and the piece that worked its way through
both ventricles was 6 cm long.

  Aside from intense chest pain, the patient did not seem to suffer any
cardiac effects from envenomation.

  Mike Darwin
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ccml Stingray again!