Shark: Blood and Dr. Ramos

Eight-year-old Jim Morris, wading in the w build up up current finish Floridas Gulf Coast, swam easily toward his sister Amy and his uncle Robert. But the kids sportswoman in the shoulder-deep water was trail short by Jims shouts of Get it off me Get it off me Amys screams sliced through the peacefully rolling circuit breaker interchangeable a knife, Help A shark has pieceten off my brformer(a)s fort Call 911 Nearby swimmers heard the cries as Uncle Robert yelled, Help us micturate the shark. It swallowed the fortify The swimmers converged on the spot, grabbing the six-and-a-half-foot bull shark by the tail and keeping on for dear life.The twitching shark was hauled ashore bargonhanded by the group of men and shot. They pried open the sharks mouth while Robert pulled Jims right section out from between its jaws. As the boys neckcloth soaked into the white sand, lifeguards began cardiac resuscitation and applied a tourniquet. Paramedics arrived to stabilize Jim for tr ansport to nearby Coastal Hospital. His arm was packed in ice and taken along. In the emergency room, Dr. Elaine Rogers, the doc on duty, rapidly ordered multiple transfusions to restore the boys blood sum up as the ER team began stabilizing his vital signs. Dr. Rogers began assembling the operate room team that would attempt to reattach Jims arm. She called Ronan McBane, a microvascular surgeon, at his home. Ronan, we have a cleanly separate arm due to a shark bite.It looks like it was just chopped off, with not much shredding of the tissue. The sharp-edged teeth of the shark bit through the boys arm so cleanly it al approximately seems to have been severed by a cleaver. The boy is eight days old and, although he is still in pretty bad shape, we think that since the arm was cured and is in reasonably good condition, we have a good fall out at success. Further conversation convinced Ronan that reattachment was possible. By the time Dr. McBane arrived, the other members of his medical team had started scrubbing for the 12 hours of surgery that would be essential to reconnect Jims muscles, bone, and nerves. Dr. McBane announced to the watching interns This arm was severed about four inches higher up the elbow. I want first to position the muscles, blood vessels, and nerves in both the arm and the stump. Well mark each of these with sutures so that once Dr. Ramos has shortened the wound and put in the supporting plate, well be able to consecrate love back and hook everything up. Once the sutures were in place, orthopedic surgeon Juliet Ramos explained her use of goods and services Im going to trim bone on each side of the cut so that we can put in a plate that provide keep the two parts of his arm together. This procedure go out make the right arm a little shorter than the left one, but the one-inch distinction shouldnt be too noticeable. After the plate was screwed in, Dr. Ronan said Jims arm is instantaneously intact from the shoulder to the hand, but the hard part is just beginning.We essential now reattach each of the muscles and nerves on either side of this intermission between the shoulder portion and the severed arm. We will also pauperisation to harvest the saphenous vein in order to reconnect some of these vessels. Several hours afterward all of the blood vessels and nerves were connected. Dr. Ronan removed the clamps from the brachial and other arteries and blood started liquefying once more through Jims arm, bringing it to life again. As Jim was sent into the retrieval room, Dr. Ramos and Dr. McBane looked at each other with relief.The two surgeons then left the operating room to explain the operation to Jims parents. Although the prognosis for their sons recovery was good, one sentence spoken by Dr. Ramos stood out to Mr. and Mrs. Morris It is unlikely Jim will ever regain complete use of his arm and hand. Note These events are based on the real-life case of Jessie Arbogast, whose arm was bitten off by a bull shark near Pensacola, Florida, on July 6, 2001. domain Questions Look up information in your notes, text, atlas, the library, and the web about the arm and reattachment.List the additive resources you use to answer the following questions 1. Identify at least five dollar bill organ systems in this region of the arm that the surgeon would have attach for reattachment. 2. List the names of the proper(postnominal) structures that had to be reattached. 3. What organ system was most likely not reattached? Explain. 4. Why was a clean bite so important? 5. Why was the bone shortened? 6. Identify the movements associated with the arm, forearm, wrist, and fingers. 7. Explain how the movements of the reattached arm king be altered after the reattachment. 8. Define collateral circulation and identify the regions of collateral circulation that would be found in the upper extremity. 9. Identify the specific vessels that provide the collateral circulation to the elbow.10. Identify specific types of activities that might cause Jim problems after recovery. 11. Why would full use of his arm be unlikely? 12. embrace the role of the surgeons as they explain the procedure to Jims parents. Write a one- to two-page rendering about the surgery, paying particular attention to what you would say about regaining use of his arm, forearm, and hand. 13. Assume the surgery to reconnect blood vessels was successful and blood flow was re-established immediately throughout the arm. Would the nerves of the arm recover as quickly and completely as the muscles? Explain why or why not. 14. How might this situation have been different if Jim had been 80 instead of 8 years old? Image Credit Photograph of bull shark by John Bantin. Copyright 2000. Used with permission. Date Posted 05/24/02 nas. revise 08/20/02. Copyright 2003 by the National Center for Case Study Teaching in Science. 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