It sounds like a mildly far-fetched episode of Grey's Anatomy, but medics in County Durham in northeast England really did have to perform life-saving surgery on the street after a man was stabbed during an attempted robbery.
When doctors arrived at the scene in Horden back in August 2017, the victim had entered cardiac arrest and was given a 1 percent chance of survival. Experts were worried he would not survive the half hour journey to the hospital and so resorted to other means: street surgery.
"When we arrived there was quite a lot of blood on scene. The patient had no signs of life – he wasn’t breathing, there was no eye movement and we couldn’t feel a pulse either, so we knew the patient was in cardiac arrest," Dr Chris Smith from James Cook University Hospital in Middlesborough, UK, said in an interview with the Great North Air Ambulance Service.
"From that moment we’ve got very limited time to be able to do what we need to do."
Smith led the operation – a thoracotomy – with support from the air ambulance crew. The procedure required cutting across the chest to expose the heart and lungs, allowing the team to release a blood clot that had built up around the heart and bind the bleeding blood vessels. Post-surgery, doctors administered a blood transfusion and the heart began beating.
The situation and location were by no means ideal, but the surgery proved to be a success. The man survived, if with life-changing injuries.
"It’s probably the best feeling we can hope for as doctors and paramedics. We’re always hoping to have a survivor from a procedure like this," said Dr Smith.
"I think it’s proof that if everything works in terms of the patient getting good care on the scene straight away, if we can utilize the aircraft or the car and get the team to the scene as quickly as possible, then we can make a difference to that patient."
"I’m fairly confident from my previous experience and seeing these patients coming in to the accident and emergency department in that state after 30 minutes in the back of an ambulance, then he would have died. I’m just glad we could be there that day."
There are various challenges you might expect to confront while performing heart surgery at the side of the road – traffic, noise, contamination, and pigeons being a handful. Interfering wasps, apparently, are another.
"I was asked to hold what was left of the left lung at the time, just so the doctor could tie it off and stop the hemorrhaging," air ambulance pilot Jay Steward told The BBC.
"And on top of that, I was having to waft away wasps, because one had landed in the middle of his chest as we were doing all this."
This might not be the first time a thoracotomy has taken place outside the hospital but the ambulance service involved say it is the first time it has been filmed outside a hospital. The resulting footage will now be included in emergency service training programs, which is why we are hearing about it now.
As for the attacker, who committed the stabbing – they have pleaded guilting to wounding with intent and robbery, and have been jailed.
[H/T: The BBC]