February 10, 2021

UAB trauma team responds to a patient in need

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trauma amputation headshotsBlayke Gibson, M.D., and Donald Reiff, M.D.On Jan. 25, 2021, an EF-3 tornado hit the northern Jefferson County city of Fultondale with estimated winds of 150 mph. Many homes and businesses were impacted by the storm, including the home of Arnoldo Vasquez. The storm caused a tree to fall on his home, trapping Arnoldo Vasquez, a father of three, under the tree and debris from the destabilized house. Fire and EMSunits responded, but despite the presence of numerous heavy trucks, they were unable to lift the tree and free Vasquez. First responders contacted UAB’s Emergency Department for help, and our team responded with extraordinary skill, dedication, and professionalism.

Emergency Department physicians were consulted throughout the evening and into the early hours of the morning as they attempted to free Vasquez. First responders decided that—given the severity of Vasquez’s injuries, the inability to remove the tree, and the growing instability of the structure—an emergency amputation was the only recourse to free him. While their colleagues kept the Emergency Department running, emergency medicine physician Blayke Gibson, M.D., and trauma surgeon Donald Reiff, M.D., collected the necessary supplies and rushed to the site, aided by a UAB Police escort.

The surgical team had to park at a distance from the home and approach it on foot as the area around it had been devastated by the tornado. UAB nursemanagers India Alford and Sherichia Hardy had already arrived on the scene and played integral roles coordinating the efforts, obtaining blood from fire and rescue units, and preparing the area as best as possible. First responders led them to Vasquez, who was trapped in what remained of a narrow basement staircase. There, with no ventilator or IV drips available, Gibson secured the patient’s airway and provided procedural sedation while Reiff performed a field amputation of Vasquez’s leg above the knee. He performed a procedure rarely seen outside a battlefield while crouching over the patient in tight confines, illuminated mostly by flashlights, during a tornado warning.

After the procedure, the firefighters were finally able to free Vasquez, who was quickly transported to the UAB Trauma Center. Vasquez was accompanied in the ambulance by Gibson and nurse managers Alford and Hardy, who continued to provide sedation. Vasquez is now recovering.

No one in the response team had encountered a scenario like this before. When asked about their heroic efforts, Emergency Medicine Interim Chair Andrew Edwards, M.D., said, “I am proud to be able to work with such an outstanding team. They put themselves at risk to save someone’s life. They consistently go above and beyond the call of duty, and their brave actions put the needs of the patient first. It is an honor to work beside them.”

Jeffrey Kerby, M.D., Ph.D., director of the Division of Trauma and Acute Care Surgery, added, “The ability to provide this unique surgical resource in an austere emergent setting is a testament to the hard work and vision of the UAB providers who had planned for such a scenario through the development of forward surgical intervention teams. This was an incredible collaborative effort between community first responders and UAB Medicine that resulted in a life saved.”