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1 results

  • Case 12 - Tornado Bloodbath

  • from Section 3 - Meteorological Natural Disasters
  • Edited by Andrew Milsten, University of Massachusetts Medical Center, John Broach, University of Massachusetts Medical Center
  • Book:
    Cases in Simulated Disaster Medicine
    Published online:
    06 February 2026
    Print publication:
    05 March 2026, pp 93-97

  • Summary

    In the aftermath of a tornado, a 35-year-old man with a history of recurrent deep vein thromboses, on Eliquis for anticoagulation, suffers a severe chain saw injury while clearing debris. The chain saw strikes his left midthigh, causing substantial hemorrhage and limb-threatening trauma. Despite prompt EMS intervention, including tourniquet application, IV fluid resuscitation, and pain management, the patient arrives at a rural emergency department in critical condition with hypotension, tachycardia, and significant pain. The nearest surgical facility is an hour away, and helicopter transport is not feasible due to weather conditions. In the emergency department, the trauma team must navigate the complexities of resuscitation, including the challenges of reversing anticoagulation, administering uncrossmatched blood, and managing the time-sensitive issue of tourniquet removal.