It was a surprisingly quiet early May morning in a Midwest emergency department. I was partway through a coffee and enjoying the pace of the morning when the dreaded squad phone rang. We all got a quick chuckle as the nurse noted a local squad bringing in a 16-year-old male with a turtle bite; most of us thought a small pet turtle had snapped at him. Two minutes later, the squad called back and asked that med command approve Morphine for the patient. As it turned out, what was missed with the first call was that it was about a 25-30 pound snapping turtle, and the turtle was still on the patient’s face. The emergency department staff then became very busy as everyone tried to prepare for what we might see roll through the ambulance bay doors.
The staff and I had gathered several potentially useful instruments in preparation for the patient’s arrival including umbrella handles, tool box with pliers, a large cardboard box, orthopedic room cast spreaders and other potentially useful devices.
The doors opened and in rolled a-16-year old male holding a large local snapping turtle against his chest as the turtle clenched down with its jaws on the right side of the patient’s face. The turtle’s front claws were against, but not yet scratching, the patient’s anterior neck. Fortunate for the patient and the staff, the patient was surprisingly cooperative and unshaken by his situation. Staring at this scene amidst a slew of nurses and staff, the question was posed to me, “What do we do now?”
How would you handle this case? Send your solution to firstname.lastname@example.org.
We’ll print the best responses along with the case resolution next month.