Presence of Mind: Chris Durbin
Although people like to think they will react in a crisis situation with a cool head and quick action, few do it with the presence of mind Chris Durbin showed the afternoon of June 29, 2005. By remaining calm, administering basic first aid and instructing his construction crew on additional actions to take, Durbin saved a life. With the extent of injury involved, it was no small feat – especially considering he was the accident victim.
As a construction labor foreman, Durbin has frequent occasion to use a demolition saw – a round cutting wheel with diamond-edged teeth – to cut through materials such as metal, concrete and rebar. On this afternoon, he was in a ditch cutting through an iron pipe. A stickler for safety, Durbin was wearing his hardhat and safety glasses.
“A thousand times a year I use this saw to do little things, big things. So here I am in this ditch cutting the pipe, and at first I didn’t realize what happened. I stood up and my hardhat and glasses fell off. I thought what the heck,” says Durbin. “Then all of a sudden I see blood running down my chest and arms.”
The saw blade has ricocheted off the pipe and hit Durbin in the face. When he reached up to touch his cheek, his fingers went inside his mouth instead. He was cut from beneath his right eye near his tear duct, alongside his nose, down through his lips, under his chin and back to his ear. That’s when his instincts kicked in. He grabbed his face and pulled it back to where it should be.
“I saw blood shooting straight up my neck about five feet. I said out loud, ‘I’m dead,’ because I’m a hunter, I’ve dressed a lot of meat. I thought I’d hit my jugular vein or carotid artery,” says Durbin.
At that point, Durbin’s only thought was getting to his truck and the photo of his kids, Brock, 14, and Bianca, 11, that was tucked in the sun visor. He wanted their faces to be the last he would see. Still keeping pressure on his face, Durbin fell halfway to the truck; by that time his co-worker, Rich Condon, spotted him and started yelling, “911, 911!” When co-workers Chuck Hoffmeister and Larry Geiler reached his side, Durbin began quizzing Larry about how bad the bleeding was and whether it was steady or pulsing (it was steady), and then instructed him to get pressure on his neck in order to get the bleeding under control. Then Durbin began asking about his right eye because he couldn’t see out of it. When Geiler assured him the eye was still there, Durbin told him to get ice on it to keep the surrounding tissue from swelling and forcing the eye from its socket.
“I was remembering the training I’d received in the Navy and during all my years in construction, and even back to my days as a Boy Scout. You always apply direct pressure to stop bleeding, and you use ice to reduce swelling,” says Durbin.
When Pam Redman, EMT-P, and Valeria Boyd, EMT, of the St. Louis City Fire Department arrived on the scene, “There were frantic men flagging us, which is never a good sign,” says Redman. “There was another ambulance that had stopped on its way to the hospital, and that crew told us the patient had major facial trauma.”
Despite the efforts of Durbin and his co-workers, the bleeding from his wound was still uncontrolled, and Redman and Boyd quickly realized – with strong urging from Durbin – that their usual protocol of complete immobilization was not possible.
“There was so much bleeding we concentrated on getting trauma dressings on his face and neck. We used the C-collar to help hold the dressings on his neck in place,” says Redman.
Once Durbin was on the backboard and in the ambulance, Boyd positioned herself above Durbin with his head between her legs and stomach, maintaining pressure on the facial trauma dressings while suctioning blood from his airway at the same time. Redmond started two 16-gauge IVs of saline, one in his left hand and one in his left forearm. After taking Durbin’s vital signs, she helped keep pressure on his wound, too.
“There were times when Chris would actually suction himself. It was just a terrible wound,” says Redmond.
Adds Boyd, “Chris was conscious the whole time, and he kept saying he wanted to check on his kids. We were worried that maybe one of his children was at a bus stop waiting to be picked up by him. He told us later that no, he just thought he wasn’t going to make it, and he wanted to get the pictures of his kids out of the truck.”
Hundreds of stitches laterOnce at Saint Louis University Hospital, the Emergency Department and trauma staff went into action to stabilize Durbin so that he could go into surgery immediately. Durbin himself remained aware of the team’s actions – he remembers saying “Unlace the boot first, dude,” when someone was tugging on his boot to get it off – until a tracheostomy was performed. Ten hours later he awoke from plastic surgery with his face once again intact. Bruce Kraemer, MD, SLUCare plastic surgeon and associate professor of plastic and reconstructive surgery at Saint Louis University School of Medicine, led the plastic surgery team.
“The injury was to the right side of Chris’ face. He had fractured his orbit, the cavity that contains and protects the eyeball, and his cheekbone. He cut the corner of his mouth and lips and went upward through the eye and almost ruptured it, but did not,” explains Dr. Kraemer. “Basically, it was as close as he could get without killing or blinding himself.”
The bleeding finally came under control as surgeons cauterized and tied off vessels in the tissues. The orbit bone was rebuilt with plastic and steel plates and then the flap of his face was brought back up so that the muscles could be reattached and the skin resuspended.
“The surgery went very well, and we’re extremely pleased with the outcome,” says Dr. Kraemer.
Although Durbin had some peripheral vision in his right eye following the accident, the force of the saw hitting the eye was causing the retina to detach from the optic nerve. In August, Stephen Feman, MD, SLUCare ophthomologist of the Saint Louis University Eye Institute, was able to first remove blood clots from the retina liner and then reattach it to the nerve, successfully saving the eye.
“I see mainly silhouettes and points of light out of my right eye, but without Dr. Feman’s skill, by now I would be completely blind in that eye,” says Durbin.
“Chris’ attitude has made a real difference in his recovery. He always has a positive outlook on life, and I think the love he has for his kids makes him grateful for every day he has to share with them,” says Dr. Kraemer.
Back to lifeDurbin returned to work on November 1, 2005, with his smile and optimism in place. The saw ripped his tear duct in half, and he continues to have some trouble closing his eyelid completely. This summer, an eye surgeon will attempt to correct both of these problems so that he doesn’t always have to put eye drops in his eye. But if that’s not possible, Durbin says he can live with that inconvenience.
Durbin is coping with the limited eyesight in his right eye, and in fact says it has made his golf game better because he has to concentrate more.
There’s some scar tissue under his lip, but Durbin says the goatee he’s grown hides that pretty well.
His lips are numb on the right side but Durbin says – with a grin – that he thinks his smile isn’t half bad these days.
For Chris Durbin, life is good. He has two great kids who are the center of his world. He lives out in the country and loves it. He has a job he enjoys. And he survived an accident that could have killed him but instead brought him in contact with people he will never forget.
“The guys on the job, I can’t thank them enough for what they did. I think I would have bled out pretty quick. Pam Redmond and Valeria Boyd, I don’t know how they do what they do everyday, but I’m thankful they were there for me,” he says. “And everyone at Saint Louis University Hospital – I can’t say enough about them. They do a great job, they don’t get enough credit in my book.”
