My evening shift was going along smoothly until the nurse’s aide ran into the medicine room to tell me she wasn’t going anywhere near one of the patients she was assigned to because there were worms all over his bed. I stopped what I was doing, locked the medication room door, and went to investigate.
The patient was a young man in his early twenties who’d been in a motorcycle accident. He'd suffered a severe head injury and numerous broken bones. The unit I was working on was the amputee and fracture ward, so once his condition had stabilized in the acute care hospital, he’d been transferred to us for rehabilitation. He was recovering some from the head injury and was starting awaken from his coma, but not enough to understand where he was or what had happened to him. His right leg was in a cast from his toes to the middle of his thigh and was suspended in the air by traction that was connected to pins running through the bones in two places.
I approached the bed and noticed he was extremely restless and agitated. When I pulled the sheet back to inspect his leg, I found there were indeed many crawly things coming out of the top of the cast, hence the source of his agitation. Maggots. Hundreds and hundreds of maggots had hatched and were now crawling around on his skin and out the top of the cast. There were so many of them they were now falling onto the floor.
Three of the nurse’s aides were standing nearby, watching me expectantly. I told them they couldn’t just leave him like that and the worms were not going to hurt them so they needed to clean him up. I went back to the nurse’s station to call the doctor, and when I turned to check on the aides, the three were still huddled together and looking at me like I was crazy.
I placed a call to the doctor, an overworked and crabby resident who probably hadn’t slept in days, and told him the problem. He wasn’t familiar with the patient and didn’t think the situation was in any way urgent enough to bother him with. He told me not to worry about the maggots, there was probably an open wound under the cast that was infected, and the maggots would clean the wound out by eating all the dead tissue. He said to send the patient to the cast room the next day to have the cast removed and replaced.
Glancing back over at the young man who was writhing in bed in obvious discomfort, I knew this situation may not be urgent to the doctor but it certainly was urgent to the man lying in the bed. I went back to the medication room and opened a corner cupboard where I knew little used medications were kept. I took out a can that had been sitting there for months and looked at the label. Ether. I’d heard stories from older nurses about using ether to kill maggots in wounds, so I made a decision. I took the can back out to the patient’s bedside, opened it, and poured the contents inside the cast. Within seconds, all of the maggots outside of the cast were dead, so I assumed the ones inside were dead, too. The young man settled down and went to sleep after the nurse’s aides came to change his sheets and make him comfortable.
He went for a cast change the next day and I feared that when I came back to work there would be many questions about how the maggots had died. To my relief, no one asked me anything when I reported for duty the next evening.
Happily, this young man recovered from all of his injuries and was able to walk out of the hospital on his own. I’m sure he had a long recovery period, more because of his head injury than the broken bones, but hopefully he went on to live a full life. And I hope he stayed off motorcycles.
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