The Operating Room is a restricted environment, normally open only to members of the surgical team.
But on March 19, hand surgeon Andrea Halim, MD, and other team members knew they needed an unusual kind of help with a patient whose hand had gotten crushed – and caught – in a meat grinder.
The patient had been transported from Waterbury Hospital with her entire forearm and hand still encased in an industrial-grade grinder. Her hand had gotten wrapped in the augur – a corkscrew-like device that rotates inside a thick metal cylinder.
YNHH contacted the New Haven Fire Department for help removing the cylinder so Dr. Halim could access the hand. Before the procedure, three firefighters from Rescue 1 worked with the OR team to develop a plan, then used special tools to remove the cylinder. The removal was especially tricky because a power saw the firefighters used generated sparks.
“They had to be very careful about keeping the metal cool, so it didn’t cause a thermal injury,” Dr. Halim said. “The Anesthesia team also had to ensure the patient wasn’t getting a high concentration of oxygen, because of the very real risk of causing a fire. The whole team had to be involved and on point for the patient’s safety.”
The entire procedure, including cylinder removal and hand surgery, took about four hours, said Dr. Halim, who is an assistant professor in Orthopaedic Surgery and the Yale Orthopaedic Residency associate program director. She is also associate fellowship director, Yale Combined Hand Surgery Fellowship.
Besides removing the meat grinder, the most challenging part of the surgery was stabilizing the patient’s middle finger, which had been fractured and dislocated in multiple places and had substantial soft tissue damage, she said.
“This is the kind of incredibly severe injury we sometimes see caused by fireworks or snow blowers,” said Dr. Halim, who recently performed additional surgery to debride and manage the soft tissues and repair a digital nerve of the patient’s hand.
The patients’ other fingers and thumb also were injured, but not as severely. With all five fingers and a stable thumb, the patient will likely have reasonable hand function, Dr. Halim said.
“This is the first time I’ve had the fire department in the OR, but we were so glad they were there,” she said. “The firefighters’ knowledge and experience, and their collaboration with the surgical team, helped ensure the procedure was a success.”
