Whenever you encounter massive bleeding, the first thing to remember is:
it’s not your blood.
In 1989, while discussing a paper on liver injuries, Dr. Francis Carter
Nance of New Orleans made the following comment:
"I would like to offer Nance’s classification of injuries, which has the
advantage of not needing to look at the organ injured, but at the resident
who is there at the operating table…
If he or she looks at the wound and yawns and turns it over to the junior resident, then…it is going to do well.it is going to have a high survival rate.
If he looks at the injury and salivates…that means that the resident will have to do some suturing and really help the patient, and the mortality rate will not be high, and he or she will look good during the morbidity-mortality conference.
If the resident sweats…that means that he or she will do a lot of sewing, will encountera complication, and will have to defend himself or herself at the morbidity-mortality conference, and probably receive a lot of heat.
And if the resident screams and asks for the attending…you know that the patient will do poorly."