This is the happiest guy I have ever seen with a knife in his neck. Hands down.
He came in with completely stable vital signs. He had no neurological deficits and he was only in a little bit of pain. It was quite remarkable. The knife was stuck so deep that the assailant couldn't pull it out. The CTA showed that the knife was imbedded in his clavicle on the opposite side. It missed all of his important vascular structures. Lucky for him, it also missed his trachea. We took him to the operating room thinking it was going to be easy to pull it out, but we got a little surprise. It was stuck into his clavicle like the sword in the stone. I was pulling so hard on it that it literally lifted his shoulders off the operating table. Then I wisened up and grabbed his clavicle with one hand and wiggled the knife out with the other. You're really not supposed to wiggle knives out because you might cause more damage, but I had seen the CTA and knew that it wasn't sitting close enough to anything too important. Once it finally came out, we had to explore the wound to tie off the bleeding vessels. It turns out, the knife went through both of his anterior jugular veins. We got control of those pretty easily and the guy walked out of the hospital 2 days later. He was still smiling.Credit: Cape Town trauma
