Agricultural Health: The Case History Corner
Stress and Fatigue

 

By Kelley Donham, I-CASH Director

 

A farmer was brought to a trauma center with partial amputation of three toes on his right foot. He had just started the fall corn harvest. He and his wife had been unloading shell corn from a wagon into a large tractor tire laying on the ground that he was using as a grain hopper. When standing on the tire to sweep out the wagon, his foot had slipped into the tire center and become caught in the moving auger. It cut through his boot into his toes. It had started to rain lightly, and the farmer had been rushing to finish unloading before the weather got worse.

 

1. What were the primary human factors that contributed to the injury? (Select the two best answers)

a. Stress and fatigue due to long work hours and bad weather conditions.

b. The farmer's lack of awareness of a potentially hazardous situation.

c. Permitting his foot to slip from the tire rim.

d. Failure to replace the auger shielding which had broken the previous week.

 

2. When treating the patient, what factors would the physician or nurse need to consider in addition to the farmer's primary injury? (Select the two best answers)

a.       Need for a prosthesis

b.      Independent nature of the farmer, probable lack of compliance with the amount of time recommended to stay off work

c.       Psychological problems stemming from stress due to lost work time during harvest season.

d.      Probability that the farmer will not return to work soon enough to regain physical conditioning

 

3. What complicating factors would probably NOT be involved in this situation?

a.       Distance from medical facilities.

b.      Gross wound contamination with soil.

c.       Isolation of the patient from immediate help.

d.      Injury from livestock when trapped in the machine.

 

4. What would have been a logical preventive measure?

a.       Shoveling instead of auguring the corn.

b.      Standing next to the tire instead of on it.

c.       Having someone else sweep out the wagon.

d.      Placing a strong, metal safety gate over the auger opening.

 

 

 

 

Answers:  1) a, d   2) b, c   3) d   4) d