Jason’s Double Compound Fracture – July 2012

July 7, 2012

Warning: This report contains material that some may find difficult to handle.  If you are squeamish with blood or pain, proceed with caution.  I chose to publish this story because of its educational value.  Perhaps it will help others avoid similar injury, or at least be prepared to provide adequate treatment.

On the third day of our family ATV trip to the Bryce Canyon area, Jason had an unfortunate accident.  He suffered a double compound fracture on his left arm (and he is left handed).  We were lucky to have a good group of friends along, and we had a good selection of first aid supplies.  This is the story of how the accident occurred, and what type of treatment was provided.

Casto Canyon

Casto Canyon is one of our family’s favorite ATV trails.  It is not very long, but it is very scenic and fun to ride.  It is a typical ATV trail with rounded ruts on each side of the trail.  Most of the trail zigzags through the trees with beautiful red rock formations forming the canyon.

Casto Canyon

The trail is just technical enough to keep you on your toes.  Just when you think you can speed up, you come to a tight corner, a rocky stream crossing, or some exposed tree roots – nothing too technical, but enough to keep things interesting.

The Crash (~11:00 AM)

It was Jason’s turn to operate the helmet camera.  He started near the back of the pack, and gradually worked his way forward, filming each person in turn.  He had been filming Jason Wright (JW) and decided to pass and film Ryan Barton.  When the trail straightened out, he sped up to make the pass.

Shortly after passing JW, he came to a fairly large water bar bump which formed a very tempting jump.  At Jason’s speed, he got quite a bit of air (for us anyway).  Unfortunately, right after the landing there were two or three erosion ditches across the trail and the trail curved to the right.

Jason landed in one of the ditches, which launched him back into the air and threw his weight forward.  When he landed this second jump, he was unable to maintain control.  He went off the trail and got thrown over the handlebars.

Being 6’4” tall, he has a long way to fall.  Add to that the speed of perhaps 25-30 mph, and any fall is likely to hurt.  Jason landed in the last ditch, which contained numerous large rocks.  This made it impossible for him to ‘hit and roll’.  He must have tried to absorb the impact with his arms, but his bones couldn’t take that much force.

When he came to rest, he was in severe pain.  He wiggled his toes and his fingers to see what condition he was in.  He was unable to wiggle the fingers on his left hand.  He tried to sit up to take a look.  He thought there was a stick in his arm.  He also thought he looked like Harry Potter in episode two since his arm was so crooked.

Both bones snapped a few inches above the wrist.  They were fairly clean breaks and both bones punctured the skin.  One bone slid back inside, while the other remained exposed.

Jason in pain

First Aid

JW came by just as Jason was trying to sit up, so he assumed that he was okay.  He continued riding to inform me of Jason’s crash.  Taylor Wright was the first adult on the scene of the accident.  He immediately sent Peter Barton to fetch his dad, Scott (an MD), and me.  He then checked Jason for additional injuries and proceeded to help him get comfortable.

Scott and I stopped at the junction to the Barney Cove trail to wait for the rest of the group.  JW came next, and informed us that Jason had crashed.  A short time later, Peter rode up and informed us that Jason had broken his arm.

Terri Barton and Kim (Jason’s mother) were also soon on the scene.  They each fetched their first aid kits from their ATVs.  Kim provided shade and water (it was a hot day), while Terri prepared bandages and water to clean the wounds.

When Scott arrived, he immediately assessed the situation, washed the wounds as best he could, and began to apply gauze bandages to stop the bleeding.  Luckily the wounds were not bleeding too profusely.

Kim keeping Jason comfortable, Scott and Terri preparing bandages

I always carry a SAM splint in my Camelbak.  Scott was relieved when I pulled it out.  It would have been difficult to make a splint for such a serious break without a SAM splint.  I think it is perhaps the most valuable piece of first-aid equipment for dirt bikers.

Scott bandaging the wounds, Dee preparing the SAM splint

Once the arm was securely in place in the splint, we needed to form a sling.  I had a sling in my first-aid kit back at the car, but that wouldn’t help us until later.  We rummaged through our supplies and I found a small ATV cargo net in Kim’s ATV.  It made a great cradle around the arm and we simply hung it from the loops on Jason’s Camelbak.

Evacuation (~11:15 AM)

We were lucky on this trip.  Not only did we have some ATVs in the group, but Glen Taylor had a two-seater ATV.  This provided a fairly cushy ride back to the car for Jason.  We were also lucky in that we were only 3 miles from the car.  Even that short distance would have been a real challenge without some ATVs.  If we only had dirt bikes, I am not sure how we would have gotten Jason back to the car.

Loading Jason on Glen’s two-seater ATV

We secured Jason to the ATV with a couple of cam straps.  Normally we wouldn’t do that, but we were worried that Jason might pass out and fall off.  Glen did a good job of driving him back safely and talking with him to keep him awake.

Securing Jason to the ATV (in case he passes out)

Because of good communication and readily available first-aid supplies, it only took about 15-20 minutes to get the splint in place.  A few more minutes to rig a sling and secure Jason to the ATV, and we were on our way back to the car.

I headed straight back to the car to get things ready to head to the hospital.  Kim followed close behind.  We were both changed and basically ready by the time Glen and Jason arrived at the car.  We had to cut off his camelback and put on a sling in order to get him in the car.  We started for the hospital in Panguitch at about noon.

By juggling people around, Nathan Wright was able to ride Jason’s motorcycle, so we didn’t have to make an extra trip to shuttle his bike out.  Scout was kind enough to trailer it home for us, so we didn’t have to wait for Jason’s bike.  In fact, I suggested the rest of the group continue their ride since there was nothing further they could do for us.

Garfield Memorial Hospital (Panguitch, UT) (~12:20 PM)

Just as we were pulling out of the Casto Canyon staging area my phone rang.  Scott called from Peterson Point (above Casto) to see how we were doing.  He also offered great advice regarding the local hospitals and Jason’s medical needs.

It was only about a 20 minute ride from Casto to the Garfield Memorial Hospital in Panguitch.  As we pulled up to the emergency room, a nurse came out with a wheelchair.  What service!  (It turns out she was expecting someone else – someone that broke a leg on an ATV accident near Panguitch Lake)

I was very impressed with the staff.  They were courteous and provided timely service.  They immediately hooked up an IV and started giving Jason an anti-biotic and some morphine for the pain.  They opened up his splint to examine his injury, but it started bleeding so they quickly wrapped it back up.

Notice that Jason’s nurse also has a broken arm

One nice thing about a SAM splint is that they can take X-Rays without removing it.  It caused Jason some discomfort, but they took a few X-Rays showing the state of the bones inside (and outside) his arm.  Luckily both bones had fairly clean fractures.

X-Ray (top view)

X-Ray (side view)

The hospital at Panguitch is too small to handle such a serious injury, so they suggested we take him to Cedar City.  I asked if we could just take him to Salt Lake since Cedar is the opposite direction.  They indicated that immediate surgery is needed to avoid infection.  That turned out to be very good advice.

They told us we could take him to Cedar in our own vehicle, or they could transport him in an ambulance.  We elected to take the ambulance so they could manage his pain better.  Unfortunately, the volunteer ambulance was out on another call near Hatch.  We got tired of waiting, so we decided to take him ourselves.  They gave him one more dose of morphine and sent us on our way.

Valley View Medical Center (Cedar City, UT) (~3:00 PM)

It took about one hour to drive to Cedar City.  Jason was hurting pretty badly by the time we got there.  During the last 20 minutes he kept asking if I could go faster.  80 mph was about the best I could do with a trailer.

We pulled into the Valley View Medical Center in Cedar City at about 3:00 PM.  The receptionist at the ER was very unhelpful.  Even though Jason was bleeding and in a lot of pain, she would not admit us.  She said she needed paperwork and it hadn’t come through yet!  There were no crowds in the waiting room and still they wouldn’t see him.  We asked if we could just start over as a fresh walk-in rather than wait for paperwork from Panguitch, but she said no.

Finally at about 3:30 a nurse came out to get Jason.  It turns out they were expecting him to arrive in an ambulance.

It took about an hour to get Jason ready for surgery and for us to speak with the surgeon and the anesthesiologist.  They took him back for surgery at about 4:30.

Almost ready for surgery (~4:30 PM)

The surgery took about 1.5 hours.  The doctors said it went very well.  The wound required a lot of scrubbing to get the dirt out, but they thought Jason would fully recover and be ready for basketball season.  They installed two plates and 11 screws.  About ½ hour later he was back in his room with a much lower level of pain.

X-Ray after surgery

Jason resting peacefully after surgery (~6:30 PM)

By about 7:30 Jason was feeling well enough to eat some dinner.  The drugs were wearing off and he was becoming more alert.  He really did handle this whole ordeal well.  In spite of the pain he kept his cool and maintained a good attitude.

Later that night Kim and I checked into a motel room for the night.  It was sure nice to have an iPhone so I could find a motel and make a reservation without leaving the hospital.

Home (Sunday 1:30 PM)

We returned to the hospital early Sunday morning to find Jason doing really well.  He slept fairly well and ate a hearty breakfast.  He received his third and final dose of anti-biotic at 1:00 PM and was discharged at 1:30.  We got him comfortable in the car and began the 4 hour drive back to Salt Lake, arriving at about 5:30 PM. Marcy (our daughter) was kind enough to have dinner ready for us when we arrived.

Jason is doing much better

Lessons Learned

It is unfortunate that Jason suffered such a terrible accident, but it was very fortunate that we had plenty of help and adequate first-aid supplies.  Here are the items that we found most useful:

  • Having a doctor in the group (even if he is an O.B.)
  • SAM splint – a must-have for dirt bikers.
  • ACE bandage or Coflex tape to wrap the splint.
  • Clean water to flush the wound.
  • Gauze bandages.
  • Medical tape.
  • A sling.
  • An ATV (preferably a two-seater or side-by-side).

Video

In this video, Jason explains his story.  He captured the accident on helmet camera, so we can sort of see what happened.  This also allowed us to figure out how long the rescue took.

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About gardinerfamilyadventures

A really great family!
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One Response to Jason’s Double Compound Fracture – July 2012

  1. Tony says:

    Ouch! Sorry to hear about this, it’s unbelievable how well you guys handled it, worked together and made the best of it! Good documentation too, I always wish I could at least have a picture of my broken arm. Someone took one and was going to e-mail it..never did. Nice video too. We will definitely learn to take more first aid supplies on the trail from this, thanks a bunch. hope Jason is doing well. Tough kid!

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