SKMC PULSE Issue No. 8 - Sheikh Khalifa Medical City

A THORN IN MY BOY’S FOOTThis is a summary of a real story from Dr.Ahmed Ali’s book “Happened in ER” thathas been recently published in Arabic.The book is interestingly informative with anice sense of humor.We've all been there; a foreign body would enter, by mistake, into ourbodies. A child would swallow a coin, a nail or a needle, someone wouldmanage to get a wooden stick or a nail into their foot, or a little piece ofmetal would get into someone's eye, while working with metal parts.This story happened to a six-year-old boy, who was playing on the beach inAbu Dhabi, and meanwhile, a piece of metal got into his foot.The strange and funny thing is that the boy burst out screaming violently,and his family members who were with him tried hard to pull it out, butthey failed. So they called the ambulance that came to the beach, andkindly delivered the boy to the ER.Is that even possible?! To call the Ambulance for just a piece ofmetal in the foot?!Well, that is what happened, and it seems like that was the only choice.The paramedics' entrance into the ER was dramatic, and everyone overthere stood to watch that bizarre scene.I was one of those who saw the scene and helped treat the boy afterwards.Two paramedics entered, one of them was carrying the boy, and the otherwas carrying the piece of metal that was still sticking out of his little foot.It is now time to describe the piece of metal to you, it is not a sharp littlemetallic stick as you might have thought, this thing was a long metallictool, almost a meter long, ending in three sharp extensions, it looks just likea table fork, and is usually used to collect jellyfish on the beach by holdingit vertically and then strongly stick it into the jellyfish.The little boy was on the beach with his older siblings, and upon seeingthem use that tool, he decided to try it out for himself.For the first time in his life, he held the stick by its end and attempted tostick it into the jellyfish, and..OOOPS! He missed! He managed to stick itright into his bare foot, and one of its sharp extensions penetrated his footand stuck out at the other side.At the ER, it was a dreadful scene, a little boy, less than a meter tall, heldby the paramedic, while the other paramedic holds the tool, which wasalso about a meter long, in a very careful manner, for any movement wouldhave caused the boy agonizing pain. The boy was placed very carefully onthe bed, while one of the paramedics was still holding the metallic tool.The mother had been really strong, which helped the ER team a lot,She was using her mobile phone to take photos of the scene, moved byexcitement and anxiety.The aim was to take the metallic tool off the boy's foot without hurtinghim. It is important in such a situation is to deal with the child as an adult,by conversing with him and explaining in detail exactly what is going tohappen, and to avoid attacking him with a sudden pain.After a lot of persuasion and a few tears, a subcutaneous anestheticinjection was given to the boy, and he was left for a little while, then, wegot ready for taking the tool off.And that was the dilemma!The fork-like metallic tool consisted of a long metallic handle that endsin three, V-shaped extensions pointing outwards; this makes its motionpossible in only one way. Can you imagine that?That is why the tool cannot be pulled upwards, if we do so, we are goingto rip the boy's flesh off, and that is the reason his family could not simplytake it off on the beach.If the tool was a handle with only one extension, we would have been ableto push it in the direction of his foot and pull it out on the other end, but ithad three extensions.So, what can we do?The only way to take it out was to break the sharp part out of the boy'sfoot. So what we did was that we pushed the tool into the boy's foot a littlefurther, until the V-shaped extension came fully out of the bottom of thefoot, and, using a bone-cutting forceps, which is a strong and sharp nipperused for cutting bones.We went through the first attempt...Twice... Thrice ... And BANG!Finally the metal broke, and every onesighed in relief.The tool was pulled carefully and slowlyout of the boy's foot until it was out,and the X-rays showed afterwards thatthere were luckily no injuries in thefoot bones.The boy went out of the ER on his feet,hobbling a little because of the wound,holding the big tool in his little handand waving goodbye to everyone.12