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Tue Sep 5 11:59:51 BST 2006

Now, now.  Be nice.  There's no such thing as a stupid question.  Well,
okay, there is; but this isn't close.  And it is trauma-related, so give
points for that.

The trick here, of course, is that the mechanism is so bizarre.  Imagine
instead that Irwin was stabbed in the chest by a human assailant in
rural Australia (he always insisted he was more afraid of people than
other animals).  Assume further that the rumors are true: that he pulled
out the "knife" and then collapsed, pulseless.

You're a surgeon, and maybe you have a sharp knife.  The nearest
hospital is at least half an hour away, and EMS is activated.  Do you go
exploring for the hole in the dike?

I'd wager that respondees will fall into two camps: those who insist
they have nothing to lose, and those who foresee so little to be gained
that they'd rather let the poor bloke die in dignity, and anatomically
intact.  We've had that debate before, without clear winners.

Now toss in that the knife was POISONED.  Not surprisingly, the
discussion soon begins to flirt with fantasy.  

In any case, I think we can agree that backyard thoracotomy becomes even
less attractive -- and that whatever approach you select, you're not apt
to add much to our broader understanding of the disease of trauma.

In spite of my personal belief that Steve Irwin was an affable and
kind-hearted knucklehead who was certain to eventually die from his own
carelessness, I expect that history will record this as the rarest of
traumatic fatalities: the pure accident.  

It is a sad time for children and nature lovers of all ages.

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of statman2500 at aol.com
Sent: Tuesday, September 05, 2006 12:48 AM
To: trauma-list at trauma.org
Subject: Re: Crocodile hunter.

What if?  What about?  I saw on ER....Please.... 

-----Original Message-----
From: Nappio at aol.com
To: trauma-list at trauma.org
Sent: Mon, 4 Sep 2006 11:10 AM
Subject: Crocodile hunter.

I needed to ask.  If any surgeon was present when a barb pierced  the 
crocodile hunter's heart, and you had some type of sharp instrument
nearby and 
he 
progressed to cardiac arrest, what would you do?(Rhetorically
diagnosing to 
yourself cardiac tamponade)
ACLS?
Nothing?
Pericardial window in the field(not sure if this has ever been done)
thoracotomy in the field(with no rib spreader and only bystanders to
pull  
the ribs apart)

Assuming no syringe and needles were nearby of course.

BTW-a google search revealed around a half dozen deaths and one survivor
of  
cardiac injury from a stingray.  The survivor indeed had tamponade
relieved  
by pericardiocentesis from a sealed injury to a coronary  vessel.
Poor SOB 
Irwin,,I'll miss his shows. 

DN
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Crocodile hunter.