9-1-1 S2/E1: What Can be Diagnosed in the Field?

Fox’s 9-1-1 series is beginning Season 2. The series is enjoyable, but there is some definite leeway the series takes when making certain field diagnosis.

In the first episode of the season, a man gets hit with an old artillery shell in his leg. As noted on the picture on the right, by simply shining a flashlight into the wound, the paramedic declares that his femoral artery has been severed. This could be more believable if there was even some mild pulsatile bleeding, even with a tourniquet in place, at the site which is characteristic for arterial bleeding.

Later in the episode, a picture of the wound is shown with a “live” shell in the anterior thigh. The fact that it is a live shell is made by a firefighter who is former military based on the color. I can’t comment on whether or not that’s true— I’m not military— but the team does make a decent choice (since the patient is stable) to not take him inside the hospital.

When the bomb squad gets there, they are able to take this sweet x-ray in the field. It is a plain, diagnostic x-ray. There is no way for an EMS crew to take an x-ray like this. Can the bomb squad? Yes. So the show is doing it’s due diligence by having the bomb squad perform this task. However, the bomb squad would not need the military to diffuse this— my law enforcement brother who used to work with the bomb squad verified this.

What other things have you seen shows diagnose in the field that they wouldn’t be able to do?

How Fast Can Someone Bleed Out? A Real Life Example with Video

I get asked often as a medical expert and host of this blog how fast someone can bleed out from a variety of injuries. When I say fast, I think many people are doubtful. I’ve said many times that all bleeding can lead to death if not controlled, whether venous or arterial.

Recently, Bo Johnson,  a friend of mine who is an ER nurse and avid outdoors man had a very close call with nearly bleeding to death. This story does have a happy ending (thank heavens.)

Bo was riding his bike to his children’s school while carrying a razor scooter in one hand. The scooter became caught in his bike and when he fell, his neck landed on the edge of the scooter, severing his right internal jugular as well as a large muscle. What follows is video of the bleeding before surgery that Bo graciously gave me permission to post here. WARNING: The following video is a graphic representation of active bleeding.

Photo Courtesy of Bo Johnson

Keep in mind, this is a large vein, and not an artery. However, the bleeding is still quite brisk and if uncontrolled would be deadly. If it had been arterial, the blood would be a brighter red in color and would spurt from the wound, and would be more difficult to control.

Bo spent two hours in surgery to repair the injury. The jugular vein could not be repaired so was tied off. The jugular vein on the other side of the neck will hopefully compensate. He spent one night in the hospital and should be back to work helping to heal others in about a month.

All who know Bo are so thankful that he is going to be okay after this freak accident. I personally publicly thank him for allowing me to share his story, video, and photo with you so you can see just how significant bleeding can be.

Speedy recovery, my friend.