The “Lumberjack” video has been a part of the Rural Trauma Team Development Course since its beginning. The story of the video is interesting. Very briefly:
Dr. Tom Foley, a general surgeon in Marshalltown, Iowa, was one of the founding authors of RTTDC. In the late 1990s, he, along with a few others from the Rural Trauma Subcommittee of the American College of Surgeons Committee on Trauma, recognized that there was an educational gap between the principles taught in course like ATLS and how those principles should be applied by the team caring for an injured patient in rural facility. This is what prompted the original authors to begin writing what ultimately became RTTDC.
It was in the late 1990s, while working on the first stages of the this course, that Dr. Foley cared for a patient with acute appendicitis in his hospital in Marshalltown. Dr. Foley noticed an unusual pattern of scars on the patient’s neck. When Dr. Foley asked about this, the patient related that he has been injured in a lumberjacking incident in 1989. A tree limb was impaled in the right side of his neck. The patient first received care for this injury at a rural facility in the Pacific Northwest. After relating this story to Dr. Foley, the patient then said that he had a videotape of the events in that rural facility. Dr. Foley was granted permission to use this video as a part of this course.
This event occurred in 1989, so there are many things that are now dates (like the lack of personal protective gear). Still, the video can be used as a good introduction to the topic of the course – is your facility prepared to work together as a team to care for a severely injured person?
Using the “Lumberjack” video at the start of the course is optional. This is left to the discretion of the Course Director and instructors.
The full video runs about 17 minutes. The abridged version is about 4 minutes.
Points that can be made from these videos:
- Poor leadership; a team leader isn’t clearly identified until a flight nurse arrives
- No assigned roles and responsibilities for team members
- No prioritization in assessment for severe injuries
- Failure to anticipate impending loss of airway
- Failure to place oxygen, bag patient on way to helicopter because roles were not assigned
- Failure to ventilate during transport
