After nearly bleeding to death from an accidental skate-to-femoral artery incident, Colorado Avalanche defenseman Zach Redmond defied all recovery odds when he returned to the ice just six weeks later.

On the morning of Feb. 21, 2013, Redmond, who was then with the Winnipeg Jets, was preparing to play the Carolina Hurricanes that night at PNC Arena in Raleigh, N.C. The day started off with the routine pregame skate, "the most harmless skate for a hockey player," according to Redmond.

During a one-on-one drill, Redmond and former Jets teammate Antti Miettinen raced for possession of the puck. A scramble behind the net led to Redmond tripping and falling on his back in between Miettinen and the net.

Miettinen took a wide stride toward Redmond, but his skate missed the ice and accidently came down on his teammate’s leg. Redmond has since called it "the perfect step" that did a lot of damage.

Not a second later, blood began pooling from Redmond’s severed femoral artery and surrounding veins.

"I started bleeding really bad," Redmond told ColoradoAvalanche.com. "I didn’t have time to think about it. I just slid away from the net."

Redmond laid on the ice while members from both the Jets and Hurricanes scrambled to give and get help.

"I remember the whole thing," Redmond told reporters in one of his first interviews after the incident. "I think it might have scared other people that were watching a little worse. I couldn’t really see; there were so many people around."

His teammate, Anthony Peluso, rushed over and sat in Redmond’s expanding puddle of blood, putting pressure on his leg with a towel to slow down the bleeding while Perry Pearn, a Jets assistant coach at the time, was making a tourniquet out of his own jacket nearby.

"He got cut. I saw that he was in a lot of pain," Peluso told the Winnipeg media. "I just ran to the bench, grabbed a towel and got back as fast as I could. Just put my hands on it, squeezed it shut."

Jets head athletic therapist Rob Milette knew Redmond’s heart was struggling to keep up with the blood loss and that Redmond would soon be nearing shock.

"We were monitoring his vitals, checking his pulse, and his pulse was really weak and really slow. He was pale and he was telling us he was getting thirsty," Milette told the Winnipeg Sun.

STATE OF SHOCK

It was probably the most painful part - Zach Redmond

For Redmond, staying conscious while the ambulance was on its way was important for several reasons. For one, if an injured person is conscious, it is much easier to monitor the condition of the injury and assess if the patient is stable or rapidly deteriorating. Another reason is that the person can answer questions pertaining to their medical history that could assist the surrounding help and paramedics with planning potential routes for medication, surgery or treatment.

Milette told the Winnipeg Sun that Redmond "was answering our questions, talking with us, staying alert… It was unbelievable the trauma he went through and how composed he was during the process."

Noticing the commotion on the ice, Hurricanes defenseman Jay Harrison headed straight to the home team's training room and notified Carolina head athletic trainer Pete Friesen and assistant Doug Bennett that someone was injured on the ice. Carolina’s team doctor was notified and immediately contacted the vascular surgeon that would operate on Redmond upon his arrival at the hospital.

After 11 minutes on the ice, Redmond was loaded into the ambulance. Milette told the Winnipeg Sun that he estimated Redmond had lost one-fifth of his blood supply from the laceration by that point.

Redmond recalled feeling helpless.

"I just kept asking, 'When can you put me under?' I just needed it out of my hands at that point," he said to ColoradoAvalanche.com.

In the ambulance, before the then 24-year-old was put under anesthesia, the tourniquet made from Pearn’s jacket was removed and the paramedics tied a medical tourniquet around his leg.

"When I got into the ambulance they put a real tourniquet on me, and when they started wrenching down on that thing it was probably the most painful part and once I got to the hospital they put me under and did the surgery," Redmond told reporters after the accident. "So I think the worst part was pretty much the ambulance ride."

A COMPLICATED SURGERY

Redmond was transported to a hospital in Raleigh where he underwent a 3-hour surgery. Not only was Redmond’s life in danger from the injury, but also on top of that, the surgery yielded its own list of potential risks the doctors had to be aware of. Surgery involving massive arteries includes the risk of blood clotting in which the leg would not remain alive and would need to be amputated.

The basic principle of vascular repair is to control the flow of blood from both ends of the injured vessels. In order to essentially reconnect the artery, the vascular surgeon had to first assess the damage by clamping the vessel at both ends to stop the bleeding.

The medical staff had to clean the edges of the blood vessels, and then use a vein from another part of his leg to patch and secure the connection of the two ends of the femoral artery. If it's a clean cut on a small vessel, the two edges can sometimes be sewn together. However, in larger vessels with more damage to the edges, such as from a rough cut caused by a hockey skate, a vein graft or synthetic graft is used to reconnect the artery to allow the vessel to resume its ability to carry blood.

The process of splicing an artery back together, or to patch a defect with a vein, has roughly an 80 percent success rate. Stakes were high as Redmond had already suffered a severe stroke at the age of 15, causing him to relearn how to use basic motor skills such as walking and talking. This past medical history gave the emergency surgery in Raleigh yet another layer of complexity.

On top of reestablishing the blood flow through his femoral artery, other significant branches and surrounding veins needed medical attention in order to stop the excessive blood loss.

The standard blade on a hockey skate is about one-eighth of an inch in thickness, and is lined by a razor-sharp edge on both sides. In Redmond’s case, the blade cut so deeply into his leg that it sliced through his skin, muscle tissue and surrounding blood vessels as well. Milette estimated that more than 20 percent of his blood volume was lost in all, generating several additional obstacles for the vascular surgeon who operated on him.

"There were a lot of blood vessels that needed repair, along with all the surrounding tissue, the muscles," Milette said to the Winnipeg Sun. "Basically, every main blood vessel in your leg that supplies blood to that lower limb was in trouble."

The femoral artery is the largest artery in the leg and the second largest in the entire body, entering the front of the thigh just below the pelvis. It is the main supply of blood and oxygen to the leg and is about the size of a person’s index finger, approximately 7-10 millimeters in diameter.

A person has about five liters of blood in their body (a little more than a gallon), and a complete laceration of the femoral artery can result in the loss of as much as a liter of blood (more than a quarter of a gallon) a minute. That means a gash such as Redmond’s could lead to the loss of all the blood in the body in only five minutes if left unattended.

Hockey is a sport that entails running on knives, with any and everyone at risk of being cut if the end of a blade lands in the right spot, making injuries no new occurrence for the sport. Most hockey fans can recall several cringing times where a blade has cut a player, possibly the most famous being Clint Malarchuk’s carotid artery laceration. The Buffalo Sabres goaltender's neck was sliced from a player’s skate blade during a televised game against the St. Louis Blues on March 22, 1989, illustrating the constant danger hockey players endure on the ice.

Luckily at the time of Redmond’s injury, he was surrounded by teammates, coaches, trainers and staff that knew the first step of treatment was to stop the bleeding as best as possible.

AMAZING RECOVERY

Upon awaking from the anesthesia and successful surgery, Redmond knew how blessed he was to be alive.

"I’m really fortunate for the coaches and players who jumped in," he said during an April 5, 2013 media scrum in Winnipeg. "I’m convinced it saved my life. I couldn’t be more lucky."

"I didn't even feel Antti step on me. I didn't feel anything until after surgery. They had to rush in there and do things quick. They did a great job. I'm really lucky how it all happened," Redmond later said to ColoradoAvalanche.com.

Although it was an accident, Miettinen was in his own state of shock at the severity of the injury.

"The first time I woke up, I remember Antti was standing in the room. He was the first guy I saw," said Redmond. "He didn’t know how serious it would be, and he felt terrible. I remember telling him, 'It’s fine. It was a complete accident. I hope you don’t worry about it.' I felt so bad for him."

In a statement released to the Winnipeg Free Press, Jets head physician Dr. Peter MacDonald said, "We thought it was 50-50 that he’d ever play again. To have that major insult to the body, he’s lucky to be alive first of all. You don’t even think about playing after that."

Redmond rested for a week in the hospital in Raleigh where he was accompanied by one of Winnipeg's trainers. They set up a television in Redmond’s recovery room for him to watch Jets games, and after that stay, Redmond went home to Michigan where he immediately jumped into physical therapy.

"I was trying to figure out if I was ever going to play again," Redmond said. "I definitely wanted to come back, but it was kind of like ‘Alright, I’m not going to put any extra pressure on myself. I’m just going to do what I can, and work hard and if I can get back, I can get back.'"

Redmond traveled to Winnipeg weeks later for a follow up, and what he thought was going to be a goodbye trip turned into a welcome home party when the Jets asked him to stay.

"I went to Winnipeg and they were just like, 'You know, you’re a lot better than we thought and the artery is as good as it will ever be. We’ll just keep you here.' So I was packed for three days, and I ended up staying the rest of the year," Redmond recalled with a smile on his face. "It was great. I got on the ice later that week and kind of got closer and closer, and I was able to slip in a couple (games) at the end of the year (in the American Hockey League)."

Seven months after the incident, Redmond was back in Winnipeg for training camp and appeared in 10 games with the Jets during the ensuing 2013-14 season.

He credits his speedy recovery to the week he spent in Raleigh and to jumping into physical therapy soon after being released from the hospital.

"The physical therapist had me doing little stuff right away," Redmond said. "I didn’t wait around a long time and lose a lot of strength."

Going from a grim 50-50 chance of ever skating again to an astonishing 6-week recovery, the injury was a moment Redmond, his teammates, coaches, staff and trainers will never forget.

"That will definitely stick in my mind for my lifetime and for everybody involved I’m sure," Milette told reporters.

He has found a home this year with the Avalanche where he has helped bolster the team's defensive depth while also adding a little offense. As of March 23, Redmond was third in scoring among Colorado D-men with 16 points (five goals and 11 assists) in 49 games.

"[The injury] kind of put me along a different path that ended up working out. You know I look back and it kind of all led to this: I’m in a cool city now, playing in the NHL," said Redmond.

"This year I’m finally feeling better again. I finally feel back to normal. I couldn't be happier."



