Transfusion After Femur Fracture in a Cave

A 54-year-old male entered a deep cave for recreational purposes. Near the bottom of the 324-meter-deep cave, he slipped and sustained an open femur fracture and a head injury. His companions stabilized him with direct pressure for bleeding control and improvised splinting and then summoned help. Medical personnel found the patient hypotensive with an altered mental status. Arriving rescuers further stabilized him, packaged him in a litter, and then transported him. While waiting for a technical rope to raise him up a 179-meter pit, he was transfused 1 unit of blood. Twenty-one hours after his injury, he exited the cave and was transported by helicopter to a trauma center. He made a full recovery.