Finishing harpoon gun head trauma!
This 55-year-old man with a history of depression attempted suicide using a fishing harpoon gun. The patient called Emergency Medical Services, but did not speak at approximately 10:00, presumably shortly after the event occurred. EMS reported to his home where they found him unresponsive with a three-foot fishing spear through his lower jaw/throat area and head. He was transported to a trauma center, where he was intubated after rapid evaluation and then his surgical planning and procedure took place.In the days following the removal of the harpoon, the patient remained intubated in the ICU, demonstrating a consistently improving neurological exam. He was able intermittently to follow commands, and to move the left side of the body, though the right side remained hemiplegic.His neurological exam continued to improve and he was successfully extubated. He was observed to have spontaneous movement in his left lower and upper extremities, and began to recover some strength in his lower right extremity. He was able to follow simple commands, and was attempting to verbalize. However, on hospital day 23, based on the family’s interpretation of the patient’s wishes, and after approval from the hospital ethics committee, the patient was eventually transitioned to comfort measures only. He remained stable over the coming days with resolving fevers and oxygenating well on room air. Eventually, he was discharged to hospice care.
