In the early s, I took an EMT course where, following the classroom work, we had to complete a certain number of hours of clinical work at local hospitals.
For me, one of these was a day in the emergency room at the Naval Hospital. It was a fairly slow day with just minor stuff until an old pickup truck pulled into the turnaround right in front of the ER doors. A man in his early seventies got out of the truck, grabbed something off the front seat, and started walking toward the ER. At about the same time, it registered to me that he had no right arm, just a large bloody hole at the shoulder of his shirt.
We got the patient to lie down on the bed as he came in, and someone took his arm from him. We cut his shirt off, started IVs, stabilized him, and cleaned the wound while waiting for a Life Flight helicopter to fly him to a different hospital since we were not equipped to deal with this level of trauma.
In the meantime, the old man told us what had happened. He was a farmer and had been working in the field with a large piece of equipment when his arm or sleeve got caught in the machine.
When we asked where his farm was, we realized it was over twenty miles away. This guy had driven past two trauma centers to get to the Naval Hospital, which was not a trauma center and did not have the capability to take care of him.
