Luckily for the citizens of the greater Los Angeles area, we have some of the best trained first responders in the nation. On August 28, 2017, at approximately 1 p.m., Alhambra Fire Department was dispatched to a metal works and fabricator in the 1100 block of Meridian Ave in the City of Alhambra. The original dispatch was for a reported hand injury but was quickly upgraded when first arriving companies found a man trapped in a coal hopper. The worker had been standing in the machinery when it was turned on. His body was quickly pulled into the auger assembly, trapping both legs.

Initial actions by fire department personnel to free the worker were unsuccessful. With the advice from the Paramedics on scene, the Battalion Chief then requested the Hospital Emergency Response Team (HERT), which includes a trauma surgeon, emergency room resident, and an emergency room nurse. That day, it also included Dr. Marc Eckstein, Commander of the LAFD Bureau of Emergency Medicine.

Dr. Eckstein and a fellow HERT member quickly made their way to the patient. There they found a limited work space, and an atmosphere filled with coal dust. Donning masks, helmets, and flashlights, they did their best to maintain their balance against the machinery walls as they again attempted to free the man’s legs. Again, they were unsuccessful.

After medicating the patient, Dr. Eckstein and his colleague, using a pair of surgical scissors, began cutting around the calf muscle of the patient’s leg, exposing the lower portion of one of the trapped legs. Realizing their efforts to extricate the man’s legs would be in vain, Dr. Eckstein decided to perform a double amputation of the patient’s legs in order to save his life. He next requested a reciprocating saw and tourniquets.

Work conditions were far from ideal, however, all members involved did their best to work together to save the man’s life. Temperatures in the building were approaching the high nineties. Dehydration and exhaustion were becoming a factor for all involved as well. Combined with the toxic atmosphere and near pitch black conditions, Dr. Eckstein continue to put his own safety at risk.

With the first of the two amputations started, constant care was needed to control the bleeding. Finally, after some time, the second amputation was then completed, and the patient was immediately pulled from the hopper and transported with HERT members to the hospital. During the transport, the patient suffered a cardiac arrest, but was quickly revived by paramedics. Arriving at the hospital, the patient underwent emergency surgery and reportedly survived the event and is on the road to recover.

Physically drained, Dr. Eckstein exited the hopper and was quickly evaluated by EMS personnel. Though on the verge of dehydration and heat exposure, he quickly recovered on scene with some fluid replacement. The Incident Commander stated that Dr. Eckstein performed the life-saving measures with extreme risk to his life. Because of his effort, along with all involved, the patient survived the ordeal and is now being fitted for prosthetics.