This is the happiest guy I have ever seen with a knife in his neck. Hands down. He came in with completely stable vital signs. He had no neurological deficits and he was only in a little bit of pain. It was quite remarkable. The knife was stuck so deep that the assailant couldn't pull it out. We got a CTA of his neck (that's a special cat scan where we inject die into the patient's veins right when the scan is being taken. That shows us all of the important blood vessels so that you can see if any of the critical vessels are injured before you just go diving in). The CTA showed that the knife was imbedded in his clavicle on the opposite side. It missed all of his important vascular structures. Lucky for him, it also missed his trachea. We took him to the operating room thinking it was going to be easy to pull it out, but we got a little surprise. It was stuck into his clavicle like the sword in the stone. I was pulling so hard on it that it literally lifted his shoulders off the operating table. Then I wisened up and grabbed his clavicle with one hand and wiggled the knife out with the other. You're really not supposed to wiggle knives out because you might cause more damage, but I had seen the CTA and knew that it wasn't sitting close enough to anything too important. Once it finally came out, I breathed a sigh of relief, and blood started oozing out of the wound. Thank goodness blood wasn't spurting out. I had made a good choice. We then had to explore the wound to tie off the bleeding vessels. It turns out, the knife went through both of his anterior jugular veins. We got control of those pretty easily and the guy walked out of the hospital 2 days later. He was still smiling.
This guy, on the other hand, wasn't so happy:
His knife was going through his forehead and sinuses, through his hard palate and into his mouth. Again, rock stable vitals, but a knife sitting in a very precarious location. Every time he tried to close his mouth the tip of the knife poked his tongue. He was not a happy camper. Definitely not smiling like the last guy. The x-ray we got shows the trajectory of the blade. It's obvious that the guy who did this to him meant business. He put so much force into stabbing this guy's face that he BENT the blade. Amazing. Believe it or not, this guy did pretty well too.
