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First aid

21 February 2019

CT surgeon performs emergency procedure with pocket knife to save injured biker

While on holiday in Port Elizabeth, a Cape Town surgeon was able to save a critically injured biker's life by using a rudimentary tool – a pocket knife.

After being involved in a road accident in Port Elizabeth, a biker in his 40s had a Cape Town surgeon to thank for his survival.

The biker had sustained life-threatening injuries, and Cape Town surgeon, Dr Wimpie Odendaal, on holiday in the city along with his wife, jumped in to attend to his injuries.

In a statement, Netcare said that Dr Odendaal, who was first to arrive on the scene, recognised that the motorcyclist had sustained serious chest injuries and was able to perform a life-saving emergency procedure with only rudimentary tools while waiting for emergency medical services to arrive. 

Seconds after the accident

"My wife, general practitioner Dr Christa de Wit, and I were on holiday in Port Elizabeth and were driving with my sister-in-law Louise, who is a nursing sister, on a quiet, leafy back road when we happened upon the scene of a road accident," Dr Odendaal, who practises at Netcare Blaauwberg Hospital, recalls. 

"Clearly, the accident had happened just seconds before we arrived. My wife immediately asked Louise to call emergency medical services. 

"An injured man was sitting upright in the middle of the road, and a woman, clearly very distressed, was standing next to her damaged car. While he was visibly in pain, it was not initially obvious that he had sustained severe injuries. 

"Within seconds, however, the man’s condition deteriorated. He became very short of breath, lost consciousness and no pulse could be discerned."

Saving a life... with a pocket knife

Dr Odendaal and his wife immediately began performing cardiopulmonary resuscitation (CPR) on the man. 

"The veins in the patient’s neck were distended and his trachea had shifted. It became evident that he had developed a tension pneumothorax, which is a life-threatening condition where air becomes trapped between the membranes surrounding the lungs. 

"Not only does tension pneumothorax compress the lung, making breathing difficult, if not impossible, it also decreases the flow of blood to the heart and can very quickly lead to cardiopulmonary arrest. I knew that something would need to be done immediately to relieve the tension pneumothorax, or the man would have little chance of survival. 

"By this time, a few bystanders had gathered at the scene and, as I had no medical equipment in my car save for a plastic mouthpiece for mouth to mouth resuscitation, I shouted to ask if anybody had a sharp object I could use.

"I was offered a pocket knife, and had no other choice than to use this to open the fifth intercostal space anterior to the midaxillary line, which is a specific area between the ribs on the side, to relieve the pressure. If it weren't for this emergency intervention, the man would most likely have died within minutes."

Small, vital improvements

After Dr Odendaal’s intervention the patient’s condition briefly improved, and a basting needle was fetched from a nearby house, which he used to keep the hole in the patient’s side open.

An ambulance soon arrived at the scene and the emergency personnel assisted with resuscitating the man. 

"We used an endotracheal tube and bowl of water to devise a makeshift underwater drain to restore negative pressure to the pleural cavity and prevent the space from refilling with air. A large bore drip needle was used to relieve a second tension pneumothorax," Dr Odendaal explains. 

"The patient was intubated and adrenaline was administered intravenously, and soon he was stable enough that we could transport him to the emergency department at a nearby hospital."

According to Dr Odendaal, the man spent several weeks in hospital recuperating from his injuries, which included 14 rib fractures, cardiac and pulmonary contusions, a broken pelvis and a broken foot - and has since been discharged, and is continuing his recovery at home.

Image credit: iStock