Trauma Surgeon Breaks Down Every Home Alone Injury | WIRED

Hi, I'm Annie Onishi and I'm a

trauma

surgeon

and these are each and

every

injury

that occurred just at

home

. We're going to talk about all the injuries that occurred at

home

alone

, parts one, two, three and four, we don't have time. Therefore, do not panic now that the first fall seems the most severe in this series. Go up a couple of steps, take a breath, and then land on your back, which will require a lot of strength. That landing surface, so Harry's second fall doesn't seem as severe or dramatic as the first, but it's in the context of having already had a big fall and a big impact, so if his ribs didn't break before, I bet so.

Now we're broken, when our ribs break the little edges can dislodge and damage internal organs, so from behind they can damage a kidney, they can damage a liver, they can excavate a spleen, so I guess it's a bunch of ribs broken more or less. Hemo pneumothorax more or less splenic failure Marv falls down a bunch of stairs, but he's at ground level when he does it and seems to have a little less speed and strength, so I think Marv is a little younger, which may explain why you're able to recover from this

injury

a little bit quicker, so looking up and with the iron landing on your face, what that's going to do is what's called an axial loading injury, so there's a big amount of load compressing the column from top to bottom.

It is most commonly seen in the context of a young person, usually intoxicated, jumping off a bridge or the edge of a swimming pool into a shallow puddle of water and their head hits the bottom of the lake, pond, or swimming pool in the area. that we have the ground. level fall with a blow to the head on the back what worries us about these falls at ground level is something called blow to blow injury, then we hit the back of the head, yes, our brain shakes from there , but then when the brain calms down, because it sits in a cavity of fluid that also hits the front of the skull, so you may see some bleeding in the back of the brain accompanied by some bleeding in the front part of the brain as the brain swings around the skull cavity.

We know that Harry and Marv are in for a world of hurt tonight. We can see how sensitive they seem to be to what is probably more of a sensation like a bee sting. It could cause some damage if it hits you right in the middle. eyeball, yes it was really at close range, but in general, all the pellet injuries I have seen have been to the fat. If I had to guess what type of burn it will be, I'd guess it will be second degree, which is a partial thickness burn, so it burns the epidermis, part of the dermis, which is the deepest layer of the skin.

The important difference between second-degree burns and third-degree burns is that with second-degree burns you do not lose the small stem. cells that live in those layers of skin so that it heals without scarring, so even though it is marked with the mcallister m, that is not going to be permanent, I would consider it a burn, what is called a distracting injury, because the burn hurts a lot and it's so It's dramatic and the patient is so worried that maybe he didn't realize that he fell down some stairs, so Marv lost his socks, he lost his shoes, he's stepping on this nail, here it looks like it comes in like a inch or two, puncture wounds.

They have a notoriously high risk of infection, this deep little hole that is dark, warm and full of blood and is a great place for bacteria to grow, you can tell he has had good first aid training because he dunks his head in the snow , it's probably mostly steam. Coming out of his head, you can see that he's lost a chunk of hair and then the skin doesn't have that pink appearance that his hand had, so it's probably not as deep of a burn, but it's still definitely very painful, you know, I think. that at this point. um, harry and marv should really suspect that they are invading the home of some kind of psychopath with very sadistic tendencies and i would have already turned away at this point, my concern is that with glue on this new burn on his head and then feathers on the burn, I think that's going to make wound care really difficult, so some poor burn nurse is going to have to go through and pick out

every

last piece of feather from that burn and that surface area of ​​that burn is too big to put him to sleep so he would have to sit there while they pulled little pieces of feathers out of his burned skin.

I think that's going to hurt a lot having abandoned the entrance to the house through any particular door because of all the booby traps we have here. Sneaking through a window and coming across a bunch of Christmas decorations, that thin glass that you see the ornaments are made of, when it

breaks

, it splinters and those little thin pieces of glass are impossible to get out, it causes a lot of pain. of torture for both the patient and whoever is trying to remove all that glass. I'm going to kill him. Well, the patient will go home with the feeling of glass on their feet and will have to continue to keep their feet soaked and this. things will eventually work out, maybe these guys should get their eyesight checked because the ground in front of you should always be within your field of vision, so the fact that they didn't see those cars worries me a little, maybe all these heads. injuries, they may have some kind of visual defect, there's no way to really know without more testing, but it definitely makes me a little suspicious when the neck is hyperextended like that at a rapid pace with a lot of acceleration and deceleration, you can get something called a fracture of the neck. hangman, which is when the second cervical vertebra

breaks

in a couple of places it's a really unstable fracture there can be a very high risk of a devastating spinal cord injury at that level the common term for these hyperextension type injuries is whiplash actually refers to all the muscle tightness.

After a big hyperextension injury like that, we now have a couple of other injuries in rapid sequence, so not only do we have this neck hyperextension injury, but we also have a heavy object in the form of Harry landing on Marv, so if Marv's ribs weren't broken before my bet is that they are going to break now this little sequence at the very least we have at least soft tissue damage from a whiplash injury at worst cases we have something like a hangman's fracture an injury due to hyperextension of In the neck we then have a fall from a height, we have a blow to the head and then we are crushed by a heavy object that falls.

That wire is very thick and very obvious, so they couldn't see it again. I'm really worried about his visual fields. They just can't seem to see anything below nose level. It is very concerning that a crowbar is going to cause a lot of damage because it is just a heavy metal object with a lot of force directed at a particular place. He is friendly. It's hard to see exactly where this blow lands, but it looks like some sort of epigastrium, which is sort of the upper part of the central abdomen up to maybe some ribs or the sternum area, this assault with the lever right in this area to me reminds me a lot to something called a handlebar injury, so when someone rides a bike and crashes, the handlebar gets stuck in the epigastric area and crushes all the organs and bruises them, lacerates them, so it can really cause a lot of damage each time. that our bodies slow down that way.

Whether in a car, on a bicycle, or swinging on a rope directly against a brick wall, all of our organs continue to move until they hit the brick wall and stop. That's called a deceleration injury. Many of our organs including our heart our aorta small intestine our colon are tethered to the body wall in certain places so when we decelerate things break in that tether, these deceleration injuries can be really subtle, You can't necessarily see them on a cat scan unless you're a special type of cat scan or unless you have a very high suspicion of something like bleeding in the skull building up and pushing on the brain and the brain swells. , there is nowhere it can go because the skull is a fixed compact cavity, so when the brain continues to swell, the only place it can go is down and out, which is called a hernia, so after this assault with the shovel we see both boys pass out completely, total loss of consciousness, but then a couple of minutes later these boys get back up, walk around and talk this out.

I'm very concerned about something called an epidural hematoma, what that means is there's blood pooling in the epidural space that's under the skull but outside the brain and it's slowly expanding, classically, these people get a big blow to the head, maybe time with a scoop they come to and then have what is called a lucid interval, but slowly but surely, as the blood expands within the epidural space, they begin to lose consciousness again and may even herniate and die pretty quickly, so this is a story we get all the time, esp. from the ski hill or after a bar fight and everyone says okay, okay, he'll leave and then five and ten minutes later they've passed out again, so we saw every single injury

alone

at home, one or these guys are really tough. or they have a great

trauma

doctor because they will go home alone.

Well, hello, did you? What is lesson number one? Don't mess with New Yorkers because that's what's going to happen to you, but with a good solid. Right hook so normally the point of impact is the cheekbone here this is something called the zygomatic arch this is a relatively fragile bone as far as facial structures go this is usually the first thing to break when someone gets hit especially when they turn the face Looks like a pretty solid hit, but I think knowing these guys I think they'll recover just fine. It looks like Harry takes a pretty decent fall from a height and absolutely crushes this car.

Kerry is left speechless by this fall, or is it just the wind hitting him. You may have broken a couple of ribs and perhaps suffered what is called pneumothorax, which is when the lungs collapse and air builds up inside the chest cavity but outside the lungs, which could make it quite difficult to get out. . speak or say words, I think of all the injuries that we will review today, this series of injuries is probably one of the most serious. It's probably a tie between four bricks to the head from a great height versus a shovel to the head. by the neighbor, so his inability to speak could be a sign of a pretty serious brain hemorrhage on the inside, especially in the area that controls our speech, which is usually the left side of our brain.

Depends on the patient, definitely at this point Marv would need to be rushed to the hospital to be checked out for his head trauma oh a nail gun to the buttocks or face, the ER doctor could just pull that out and there's nothing important in those areas, the nail straight into the groin, which I would What you should be concerned about is an underlying vascular injury, such as the femoral vein or femoral artery, if there was an expanding hematoma, which means blood pooling under the nail, that would be a reason to go to the operating room to do a good reduction. all the exposed vasculature and remove that nail under really controlled circumstances, every fall from a height is a little different, the injury pattern is pretty recognizable, so depending on whether you have broken ribs, whether you have a broken back, whether you have other orthopedic injuries in either. your pelvis, your extremities, solid organ injuries, such as laceration of your spleen or liver from your fall, that will determine what needs to be done for you in the hospital and what long-term consequences you could expect with rib fractures, Those people are in a very real situation. amount of pain for four to six or eight weeks, but certainly a serious accident or a serious fall from a height can lead to many chronic pain problems later in life.

Here Marv is falling straight from the first floor, which is a pretty decent height and he falls. flat on your forehead and your face, which is a pretty bad way to land, all of our bone structures at that moment of impact are going to compress and therefore crush all of our organs inside, so in addition to breaking things such as your sternum, the front parts of your ribs potentially your arms any fall from a height, no matter how you land, you will probably ruin some things we suffer more brain injuries when the brain swings inside the fixed cavity of the skull than just from direct hits this pile of tools lands on it, where things just fall from the top down and just compress the skull at the top of the neck and the spines would definitely expect some brain trauma with this potentially some neck trauma,It looks like they also hit the shoulder and arms and a few other things, so we'd really have to check this guy out carefully for other orthopedic injuries.

This really reminds me of a phenomenon we have here in central Oregon called black ice that occurs at night when only the water vapor in the air freezes. cement and forms this little imperceptible layer of ice, so from the months of October to January we get tons and tons of patients like Marv who slip and slide on the way to the car trying to regain their balance and walk away. It is very common to see broken arms, broken wrists, broken ribs just from a big fall and some cement. Another injury we see here, which is a really scary injury, is something called a straddle injury, so as Marv slides into this rack, we can see him crash. this post between your legs at a decent speed, whether it's a motorcycle or a bicycle, commonly a fence post, when someone jumps over a fence, it gets stuck between the legs and obviously it's a series of very unpleasant injuries that can lead to urogenital trauma which can cause rectal trauma which can cause bruising in places where you don't really want bruising and can be very difficult to treat and very difficult to control.

I know I keep saying this, but I actually think this is the deadliest mechanism we've seen to date. This is a high voltage electrical injury as the current travels through the body, the body's tissues act as a resistor producing heat as the electricity travels through almost anything in the line of fire from that source to where the patient is grounded, they will simply fry more. Dangerous things that can happen are cardiac arrhythmias, so the heart is an electrified organ, so a large dose of electricity will send the heart into all kinds of crazy rhythms, it can cause kidney failure, it can cause muscle tissue anywhere of the body, basically. melt and liquefy, which leads to something called rhabdomyolysis and can lead to something called compartment syndrome, whereby all the tissues in the body become damaged and start to lose water and swell.

I think Kevin McCallister needs help. This is an explosion and a fire. inside a closed space of a toilet and a small bathroom, an inhalation injury is what happens when a patient suffers a burn in a closed space, so it is most common that inside a car fire, the pathways airways are subject to superheated air and other burning chemicals, leading to There is severe inflammation of the airways to the point that the airways can swell and close, which will be a giant heat sink with a lot of mechanical force. from the explosion directly to the face and respiratory tract.

I probably think this won't be an injury I can survive, but maybe I'll be proven wrong. My biggest advice to these guys would be to stop pulling strings and strings in this house because only bad things happen when you do. This is a construction accident I have seen many times. My number one recommendation is that you should always have a friend when using a ladder, even if you think it's simple, even if you think it's safe, just have someone down there stabilizing things, I mean, Harry has Marv, Marv has Harry, that's the beauty. of your relationship, you seem to be about five or six feet off the ground and you hit your head, you're definitely going to sway with that impact, there's definitely a high risk of getting a concussion.

I am really surprised and amazed by Marvin Harry, Home Alone, Part Two, This House. of horrors is much more dangerous than the house in Chicago. I think these injuries seem a lot more serious, but regardless, they really did a great job of getting up, dusting themselves off, and continuing with a quick little anatomy lesson on the nose, so most of the nose that you can feel is actually made of soft, squishy cartilage, so it is not likely to break or deform in any way, so usually if patients have broken their nose, it does not appear crushed in the front like these two do. boys have what appears to be flattened to one side or if it has been broken in this way it looks flattened but only between the eyes and then very very swollen accompanied by a pair of black eyes also in medicine and surgery we talk about it. something called ld50, which means the lethal dose of something to which 50 of the people exposed will die. ld50 for a fall from a height is largely accepted as four stories, so anyone who falls four stories or more has a greater than 50 chance of death.

I think this particular incident is especially dangerous for Harry, who falls from what I would consider a lethal height, then his friend lands on top of him, and then a bunch of paint cans fall from higher up and land on top of him too, like this. Those are three quite dangerous ones. mechanisms all at once, I think that the pecking itself is not so dangerous; However, if you spend a lot of time in close proximity to pigeons, they carry a number of zoonotic diseases. Zoonotic means a disease you can get from an animal. that can be quite dangerous for humans, there are a couple of different types of pneumonia that you can get from a pigeon, namely something called histoplasmosis.

All my friends who live in New York, if you see a pigeon nesting on your windowsill, you should try to get rid of them because they have these little mites and apparently they can crawl through your window and infest your bed and then infest you. There you have it, that's how each and every injury was at home alone.