If you work on a farm, sooner or later you’ll probably get hurt, and statistically that injury most likely will involve your fingers. What do you do when you severely cut or lose your fingers in an accident?
The statistics paint a clear picture of the industry. According to the United States Department of Labor, farming and other agricultural work are ranked as the eighth most dangerous profession in the country. The most common on-the-farm injuries — 26 percent — involve fingers and hands, according to the National Institute of Occupational Safety and Health.
“This is the time of year, as farmers start getting back on their land after winter, we start seeing injuries,” said Dr. Brandon Libby, attending emergency room doctor at Northern Light Eastern Maine Medical Center. “It’s not uncommon to have a piece of clothing get stuck in a [farm] machine, and then the fingers or whole hand gets sucked in.”
How do finger injuries happen on the farm?
Just about every piece of working farm machinery can grab, cut, smash or rip off a finger or even an entire hand.
Farm implements such as augers, brush mowers, corn pickers, hay balers, harvesters, combines and tractors that power them have numerous moving parts on which a piece of loose clothing can get caught and pulled, taking a hand or arm with it.
Modern farm equipment has come a long way with regard to safety — moving parts now have shields or other metallic coverings that reduce or even eliminate this risk. But it’s not foolproof, and farming accidents still happen.
Just ask Henry Perkins.
When accidents happen
Eight years ago, Perkins, now 68, was combining an oat field for a local farmer in Sidney, Maine, when he heard an odd noise in the combine’s motor.
A farm combine is a large, self-powered machine for harvesting grain and operated by a single driver. It can combine three separate farm chores — reaping, threshing and winnowing. The grain is then passed through an enclosed chute into a waiting truck.
Perkins was waiting for the truck to come to the field when he decided to check out that odd noise.
“I wanted to check out what sounded like a noisy bearing.” Perkins said. “I got out of the combine, opened [the hood] and leaned in to look. I thought my left hand was braced on the safe side of the radiator.”
While examining the bearings with his right hand, Perknis said he started to hear another strange sound.
“I looked over and my hand had gotten pulled into the fan on the radiator,” he said. “That was the odd noise I was hearing.”
Strangely, Perkins said he felt no pain at the time, only a solid tug on his hand as the rapidly spinning blades hit up and finally jammed up against his fingers.
“The motor [on the combine] was still running,” Perkins said. “There was no way to shut it off to stop the fan.”
With his hand trapped in the fan, the motor running and the key to switch it off far out of reach, Perkins had to think fast.
“I ended up using my elbow to push on the flywheel controlling the fan belt,” he said. “That loosened the tension enough that the belt just came off and stopped the fan.”
Perkins then spent the next 20 minutes disengaging his hand from the fan.
“My hand was all chopped up,” he said. “The worst was my thumb that was almost totally cut off but dangling by a thin strip of tissue.”
What to do if you lose a finger
According to medical professionals like Libby, knowing what to do in the first minutes after a serious farm accident that cuts or rips off a finger is crucial to not only saving the digit, but also your life.
“The most important thing is to control the bleeding,” Libby said. “This can be done by putting pressure on the bleeding area, putting ice on it or applying a tourniquet.”
It is also helpful to keep the hand from which the finger was accidentally amputated, elevated to a point higher than your heart. This helps reduce the flow of blood to the injury.
The next thing to do is to try to locate and recover the finger.
“You ideally want to take the finger and then wrap it in a moist towel,” Libby said. “Then put the wrapped finger in a watertight, plastic bag, and put that bag in ice.”
It is crucial that the ice does not come in direct contact with the amputated finger, he said.
Doing so can freeze the tissue and actually speed up decomposition. You want to chill it to preserve it. Don’t worry about cleaning it first, Libby said. That can be taken care of by the medical professionals.
Time is of the essence, Libby said, especially if the injured area from which the finger was cut or ripped off is bleeding excessively. It is more important to get to the hospital than spend time searching for the missing finger.
“A majority of the time there is not a lot we can do depending what finger it is and where the amputated occured,” Libby said. “But the sooner you get to medical care, the better.”
Get to help
Perkins was alone at the time of his accident, so he had to get into his own pickup parked nearby and drive the 4 miles to the farmhouse, and ask to be taken to the hospital.
“I had a roll of paper towels in the truck and used them to try and stop the bleeding and try to put the thumb back to where it was supposed to be,” he said. “Then I drove about 100 mph to the farmer’s house and said, ‘take me to the hospital.’”
Perkins said the farmer was pretty taken aback by the amount of blood coming out of his hand, plus what was already inside the truck.
“As we were driving to the hospital, [the farmer] turns to me and says, ‘Do you mind if I pray?’” Perkins said. “I told him, ‘just drive the damn truck,’ so he was driving and praying, and I was sitting on my side bleeding and not praying.”
After being seen at a hospital in southern Maine where doctors were unable to take the necessary medical steps to help him, Perkins ultimately ended up at Massachusetts General Hospital in Boston where doctors performed a surgical procedure immediately to clean all the injuries to the hand. The following morning, he said, there was a second surgery to reattach the thumb.
How do you treat an injured finger?
Finger injuries like Perkins’ on the farm vary in severity from being a painful nuisance to life threatening, according to Libby.
Getting your finger crushed, Libby said, results in what is medically known as a subungual hematoma. Anyone who has crushed a finger tip knows that, while it won’t kill you, it sure hurts.
“The space between your fingernail and nail bed fills up with blood,” Libby said. “It creates pressure that can cause a great deal of pain.”
Taking a sterile pin or needle and inserting into the nail on the injured finger is a painless process that releases the collected blood and reduces the pressure, thus reducing the pain.
If the finger was crushed hard enough, it could cause the bones to break, and Libby recommends having the injured digit X-rayed if that is a possibility.
Perkins did the exact right thing in his case. Since he was alone, he did not waste time dealing with the injury in the field and went for help as soon as he freed his hand from the combine.
Especially if you are alone, Libby said, it’s better to get to, or call for, help than spend that time looking around for a finger or piece of finger or worry about properly wrapping and icing it.
“If all you can do is grab [the finger] and bring it, fine,” Libby said. “We want to see you as soon as possible [because] your life is worth more than a piece of tissue.”
Injuries involving fingers may require physical therapy for the digit to regain feeling and function.
In Perkins’ case, that never happened.
“That thumb is ornamental now,” he said. “It’s pretty numb except for one area of nerves that if I hit, I want to pass out from pain.”
He has no use of the thumb and partial use of his left hand.
Prior to the accident, Perkins was completely ambidextrous.
“I could write my name at the same time with both hands,” he said. “Now I am right handed only.”
Looking back, Perkins knows he is a lucky man and that the accident could have been far more serious.
“Things happen in an instant,” he said. “You just have to pay attention all the time.”