Monday, February 11, 2008

Zednik's Colombian Necktie

Harrowing case from the National Hockey League yesterday. Richard Zednik catches a teammates' skate blade in the neck and severs his carotid artery. Amazingly, he skates off the ice, leaving a trail of blood, and the trainers are able to get a pressure dressing on the wound. Based on the wire reports it sounds like a primary repair was done and the guy is doing pretty well.

Interestingly, outcomes after penetrating carotid injuries are much better than those seen after blunt carotid trauma. Blunt injuries tend to be associated with extensive dissections, mural thrombi, and higher incidences of stroke. A nice clean transection (like from a skate blade) will often temporarily go into spasm or clot off, allowing for re-approximation in the OR once the ends are cleaned up. The key thing is whether the patient presents with neurologic deficits and/or coma. Some advocate simply ligating the carotid if this is the scenario, as repair will not affect the outcome.

5 comments:

rlbates said...

Wow! I'm glad he is doing well. Couldn't believe what I was reading when I saw the title of your post. Amazing!

Sid Schwab said...

Yikes! I don't watch hockey much, and I hadn't heard. Good outcome all around; and you're absolutely right about blunt vs sharp. I saw a couple of each, back in the day. Of course, it helps to be a pro athlete, not only because of conditioning but because there were medics right there!

Anonymous said...

How much of the success would you attribute to having the team physician there to immediately render aid?

As opposed to calling 911, and waiting for an Ambulance?

Anonymous said...

Speaking of carotid arteries, there is a chiropractor about 20 miles from where I live (in your state),who was doing some kind of neck adjustment on a young man (his 20s) two weeks ago, who evidently pressed so hard on his neck that he ruptured the guys carotid artery. I don't understand all the details, but the guy is now parlyzed and in really bad shape.

Buckeye Surgeon said...

Anon-
I read an article yesterday about the team physician (an orthopedic surgeon) who immediately put a pressure dressing on the vessel. The biggest thing, I think, was that Zednik somehow had the presence of mind to skate over to th bench when it happened for help. If he would have just dropped to the ice, he may have bled out....

As for chiropractry: "Dr Joe", the friendly neighborhodd chiroquack renting space in a strip mall, banking a roll by cracking backs may be more dangerous to your health than al-qaeda...