Rescue situation in a missionary hospital

I had hardly slept the night before anticipating the complexities of operating on this man’s neck. He had a mass bulging out under his right mandible which looked like a bunch of large grapes with bearded skin stretched tightly over them. The mass was smooth and lumpy and about the size of a large grapefruit.  After a horrendous intubation, I had dissected the skin off the mass and was working my way around the lateral side underneath the tumor when I got into the jugular vein.

As the blood gurgles into the wound I quickly put my finger over it with a gauze pad between me and the large vein, what do I do now? I’m definitely in uncharted territory. I calmly ask Johnny to put on some sterile gloves and hold pressure on the wound. As he holds the man’s lifeblood from escaping under his finger I continue to methodically and painstakingly dissect the rest of the mass off the mandible, the trachea, the carotid artery and the deep muscular neck structures. An hour later, the mass is out.

Johnny’s fingers are paralyzed in position and totally numb. I ask him to gently take off pressure. Blood surges into the surgical field. He quickly presses back down. It’s then I remember that Erling gave me some packets of this miracle powder (Celox), finally, Brian locates the small, white plastic bag with Celox in big red letters. Brian opens the sack and I say, “ready” and lift off the gauze as he quickly pours in the powder and I reapply pressure. Five minutes later I lift off the gauze and see white powder in the wound but no bleeding. I irrigate the powder out of the wound but at the end I am trying to wipe out the last fragments and the blood gushes forth again. We repeat the process and the second time I’m a little gentler. It holds and I close the muscles and skin and send him out to the hot, sticky wards, two days later he’s complaining of a sore throat but sitting up, breathing normally and taking liquids. His neck has virtually no swelling at all.