DHS, ANIIMS successfully manage life-threatening poly-trauma case

Port Blair
3 Aug 2017

RK a 31 year old worker, with the Forest Department at Diglipur, met with an accident when the motorcycle he was riding collided with a bus near Kalighat Power House at around 1:45 pm on 27.12. 2016. His right lower limb was shattered with comminuted compound fractures of his thigh, leg and a crush injury that had fractured almost all the bones of his foot,he was also losing a lot of blood. With the help of the local public and the Forest Department officials, he was immediately shifted to Diglipur CHC. The Chief Medical Officer of the CHC Dr. Jaya Biswas and her team attended to the patient. The patient was in hemorrhagic shock due to excessive loss of blood from his injuries. 2 units of blood were immediately transfused and the right lower limb was splinted after dressing the wounds. As the regular Helicopter was not available,with the help of the DFO (Diglipur), a Navy Helicopter was arranged, which airlifted the patient to Port Blair within a matter of 2 hours.
The ANIIMS G.B.Pant Hospital Orthopaedics department had been informed of the airlift. HOD Dr. Amit Ray and Dr. Sunil Baliga, Senior Resident in Orthopaedics were waiting for RK who arrived at the hospital by 8.00PM. The teamimmediately started resuscitating and stabilizing the patient. RK was in a state of shock and his blood pressure was unrecordable. 2 more units of blood and innumerable units of IV fluids were transfused. The multiple wounds in his right lower limb were thoroughly washed and sutured. The fractures in his lower limb were stabilized with POP slabs. The right foot was crushed and looked unsalvageable. The patient was finally stabilized by about 2.00 AM.
At 8.00 AM next morning, he underwent fixation of the femur (thigh bone) with an Intramedullary Interlocking Nail and debridement of the foot. The bones in the foot were tentatively fixed with multiple Kirschner-Wires. 5 days later, on 2.1.2017, the tibia was fixed withan Intramedullary Interlocking Nail under spinal anesthesia.
The patient was then referred to mainland on 5.1.2017 for further plastic surgery. RK’s brother MK said “The doctors there were shocked to note that a person with such grievous injuries was so efficiently managed. In fact they also were astonished that the patient was referred to them as they had only very little to do to complete RK’s treatment.”He underwent plastic surgery to reconstruct his foot and only three toes were amputated due to gangrene.
The patient retuned to Port Blair on 8.2.2017. He was readmitted in ANIIMS GB Pant Hospital for rehabilitation. He reported back to duty on 1.06.2017.
It is improbable that anywhere in India, except for the Andaman and Nicobar Islands, a patient with suchgrievous life threatening injuries,more than 300 kms away from the nearest Secondary Medical Center could have been managed without loss of life or limb or permanent disability.
In a release, the Department of Orthopedics, ANIIMS GB Pant Hospital has expressed gratitude to Dr. Shipra Paul, Director of Health Services for coordinating the entire exercise, Dr. Jaya Biswas and her team at Diglipur CHC, the Indian Navy for airlifting the patient at a short notice and the Plastic Surgeon affiliated to the DHS who reconstructed his Right foot.