Mid aged man presents with 1.5m steel rod penetrating through the skull up to the genitals and beyond attracting all major specialities in one surgical table~ Neuro-Stomatology- ENT-Thoracic-Cardio-General-Uro-Ortho-
Dr. Lubuulwa,
you should contact Professor Kenneth Boffard from Milpark Hospital, South Africa. He is one of the senior trauma surgeons at that academic level 1 trauma center. As I remember he had a patient who fell on a 2 meter long iron rod perineum first and was spiked pelvio-abdomino-thoracally consecutively. The accident happened in a mine shaft far in the depth. So Kenneth Boffard has real life hand on experience with this surgical complex despiking task.
Generally speaking, independent of injury or disease the ATLS principles apply to "treat first what kills first". I hope this helps you further.
Kind regards,
Dietrich Doll
Did the patient arrive alive to the trauma bay? If yes, I would apply the ATLS premise that you treat first what would kill faster.
it doesn't look like his major vessels were affected. He will likely have neurological sequela since it looks like his frontal lobe was damaged.
Please let us know how it went.
Best regards,
Alice Gallo
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