They had to cut his clothes off around the 10cm nail that was protruding out of his left sided chest with only 2cm above the skinline. And when his chest was all clear of clothing, you could see the nail moving up and down into the chest wall. They were thinking of just pulling the nail out in the Emergency Department but after seeing the nail pulsating in and out like that, they thought it might be abutting the heart. So he had to have a CT scan. CT scan showed the nail was just 2cm from abutting the heart. The guy was lucky. Otherwise he'd have cardiac tamponade.
So they pulled out the nail in the ED (under local anaesthetic okay!!!) and will watch him overnight in case he develops tension pneumothorax (also life-threatening).
Funny points about this case:
1. The patient was laughing and smiling! Clearly it did not hurt that much or he didn't understand the complications of this injury
2. The doctors tak tahan nak ketawa tengok patient nih. They even took photos and videos (which looked quite rude). The nurse explained to the frustrated father of the patient that "it's for their education". The politically uncorrect moment was spoiled when the doctors were giggling over the photos/movies that they took. Education la konon!! More like entertainment.
3. There was no blood whatsoever. I tell you.. 6 years doing Medicine and I have not seen any bright red blood except for 2 occasions: childbirth and me blotching an IV cannulation attempt on a warfarinised patient! Other than that, I vouch that it is pretty safe for someone who's afraid of blood to study Medicine.
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