A South Texas man was bleeding out from a major arm injury. Would help get there in time?

The story was originally published by the The Dallas Morning News with support from our 2022 National Fellowship.

He knew he had to make it back to the house, or he was a dead man.

Image of a person hunted deer

or years, Scott Mussey had hunted big game with a bow and arrow and had seen animals bleed out. Medical helicopter paramedics gave Mussey the first unit of blood — which they began carrying in 2018 — before his flight to University Hospital in San Antonio.

Scott Mussey

At the end of his driveway, Scott Mussey was tinkering in the afternoon heat with an old grass shredder he’d bought at auction. Part of the machine was rubbing against the tires, and he wanted to shave it down to prevent any damage. He lifted the tires off the ground with a Bobcat and reached for a grinder, a tool he had used countless times.

This time, he heard a strange sound, like something breaking.

He looked down. Blood spurted from his left forearm.

For years, Scott, 49, had hunted big game with a bow and arrow.

He had seen animals bleed out, so he knew: He didn’t have much time.

He didn’t know if that might be 5 seconds or 5 minutes. But he was certain of this — his wife, Melissa, had no reason to check on him for the next few hours.

He had to make it back to her.

Inside the house, Melissa was at her computer, plodding through the last few minutes of her workday, when the sound of the interior door to the garage bursting open startled her.

It was April 2021, when the world was mostly working remotely. The couple worked from their home in the country, about 40 minutes south of San Antonio and more than 30 miles from the city’s best equipped trauma hospitals. They had built the house together on 12 acres in Pleasanton, close to family and friends yet secluded.

After he saw the blood, Scott sprinted about 30 yards across the driveway and through the garage. A trail of blood sprayed across a sawhorse, a green plastic storage bin and a trash bag overflowing with shoes. In the moment it took to fling open the door, crimson drops spattered the floor.

“Melissa!” he yelled. “I need an ambulance! I need a tourniquet!”

Melissa heard him shouting and assumed this was one of his jokes. Still, the edge in his voice told her to go see what was going on in the hallway.

She rounded the corner and saw the blood.

I don’t have a tourniquet, Melissa thought.

Instead, she ran for bath towels. She passed the guest bathroom — they couldn’t use the white ones — and darted into their daughter’s bedroom, grabbing a blue towel.

That’s not big enough, Scott said when she returned.

Melissa could not process what he was saying. In her shock, she grabbed a small hand towel instead of a bath towel.

Ignoring him, she used it to put pressure on his upper arm. There was so much blood she couldn’t see that the wound was actually below his elbow. Scott sank to the floor beside their kitchen counter.

He wanted to get in the car. Melissa had driven him to the hospital before, when he fell and dislocated his shoulder while climbing down from the attic. With every bump he had screamed in pain, his arm hanging unnaturally.

This was much worse. The towel and Scott’s clothes were becoming saturated with blood. Melissa knew he wouldn’t make it.

She dialed 911, setting the phone on the ground so she could maintain her grip on Scott’s arm.

On speakerphone, the emergency dispatcher told Melissa to raise Scott’s arm above his head.

Relief swept through her body. They were not alone.

Image of medical helicopter

A medical helicopter airlifted Mussey to San Antonio. The flight to University Hospital was long enough for Mussey to receive a second unit of blood.

Scott Mussey

Each minute still felt agonizing. Emergency responders were 10 to 15 minutes away. As she continued to press as hard as she could, Melissa watched the blood creep steadily across the tiles.

Scott focused on staying calm. If he panicked, his heart would pump the blood out faster.

When Melissa wasn’t assuring Scott he would be OK, she was pleading with God to make her words true.

Seven miles away, a medical helicopter took off.

On board was Rolando Longoria, who had worked for more than a decade as a flight paramedic. Dispatch said there was a bleeding patient — and mentioned something about a bobcat. They didn’t know if they were responding to a machinery mishap or a mauling.

As the helicopter circled, Longoria could see a parked ambulance and vehicles from the sheriff’s office driving down the long gravel path to the house. He wondered if they would get called off. Then dispatch sent another message.

Get ready to land. The patient has major bleeding.

Longoria and his crew landed the helicopter on the nearby road. They gathered a trauma kit, a cardiac monitor and a bag of blood before heading up the path.

When they reached the ambulance, they saw Scott, stricken, gray and covered in blood. They didn’t have much time.

County paramedics had already applied two tourniquets. A medic with military training wrote the time on Scott’s forehead with a Sharpie: 1605. Scott had felt no pain from the wound, but the tourniquet pressure was excruciating. He was sweating profusely and incredibly thirsty.

He wanted to talk to Melissa, who had been ordered inside, and his daughter, who wasn’t there. He wanted to say he loved them one more time.

Image of a person with plaster on their hand

After the accident, Mussey had to have three more surgeries and occupational therapy to regain the use of his arm and hand.

Scott Mussey

Longoria hooked up Scott to the heart monitor while his partner prepared the blood, which they began carrying on the helicopter in 2018. They needed it for moments like this, when a patient’s bleeding was so serious they couldn’t wait until they arrived at a hospital.

“What happened?” the paramedics asked Scott, trying to keep him awake but relaxed. They changed out the soaked bandages and injected a blot-clotting medication through an IV.

Longoria wondered if Scott would crash during the trip to San Antonio, where the hospital had everything he needed: more blood and a team of surgeons.

“Are you OK with us flying?” they asked. Scott gave a thumbs-up.

Inside the house, Melissa watched the flight crew walk up to the ambulance. Why weren’t they running? Maybe it was too late, she thought, and there was nothing they could do.

Instead, a paramedic returned to the house to tell her they were airlifting Scott to San Antonio. She needed to gather her things.

Friends offered to drive Melissa while her adult children, who lived nearby, cleaned up the house. It reeked of blood.

Melissa grabbed her phone. If Scott survived, she knew he would want her to capture what had happened.

Breathing heavily, she trained her phone on the ground, walking from splatters of red in the hallway toward the large puddle near the kitchen.

It looked like a crime scene.

By the time Scott arrived at University Hospital just before 5 p.m., paramedics had given him a second unit of blood. As he entered the trauma bay, he thought about how chaotic this part of the hospital seemed. A half-dozen other patients arrived around the same time.

Before his surgery, hospital staff gave Scott more blood and placed an inflatable tourniquet on his arm.

Scott thought the other tourniquets had hurt. This was worse. It was the most pain he had ever felt, like his arm was being squeezed from his body. Time blurred.

That evening in the operating room, Dr. Reshma Brahmbhatt worked to repair Scott’s blood vessels.

Image of a person

Mussey was a longtime blood donor. He never considered that he might one day be a recipient.

The wound was gaping. As Scott was using the grinder, the spinning disc exploded and a piece pierced his forearm. It shredded muscle, tendons, veins and nerves before hitting bone. His radial and ulnar arteries, which supply blood to the forearm and hand, were severed and his biceps muscle had ruptured.

Brahmbhatt knew they needed orthopedic and plastic surgery specialists. Repairing all that damage would be complex, and time was short. If they didn’t restore blood flow in time, tissue would die.

Even so, the arm seemed salvageable. It helped that Scott received blood before arriving at the hospital. Not only did it keep him alive, but the more stable he was going into surgery, the better the chance his arm would heal.

Using a vein from Scott’s leg, Brahmbhatt bridged the gap in the arteries. An orthopedic surgeon cut vertical incisions down his arm so when blood flowed back in, there would be room for swelling.

As for the nerve damage and use of his hand, there was nothing to do but wait.

Nine months later, Scott stepped up to a wooden lectern and chuckled nervously as dozens of faces stared back at him.

Scott had undergone three more surgeries and occupational therapy to regain the use of his arm and hand. His scars, which reached to his wrist, were puckered and pink.

Image of a person with grass shedder

Mussey shows the old grass shredder that he was working that led to his arm being severely injured. He said he owes his life to whole blood transfusion, calling it a 'gift.'

He later connected with Longoria and the other paramedics who helped him that day. He had lost around half of the blood in his body, about three-quarters of a gallon. He had come so close to death, he wanted to gather every detail about how his life was spared.

Scott also had heard from staff at South Texas Blood and Tissue, the blood bank. They wanted him to share his story at an event marking the fourth anniversary of a unique program to replace blood sooner in patients with major bleeding, which had provided the blood Scott received from paramedics.

In most of Texas and the rest of the country, injured patients typically do not receive blood until they arrive at a hospital, a delay that experts say contributes to tens of thousands of potentially preventable deaths each year. Such deaths are common in rural areas, like where Scott lived, due to longer emergency response and transport times. Many lives could be saved with faster access to care, including lifesaving blood transfusions, an investigation by The Dallas Morning News and the San Antonio Express-News found.

Even though Scott balked at public speaking, he couldn’t refuse. Without that blood, he is sure he would have lost his arm, or his life.

At the blood bank one Saturday morning in January 2022, he told the crowd he was a longtime blood donor and had never considered that he might one day be a recipient. He was eager to begin donating again himself.

“I have my life, I have my arm and I have the vast majority of functionality in my arm,” he told the crowd, waving his fingers for emphasis. “It’s, in my opinion, as a direct result of the gift that I received, the gift of whole blood transfusion.”

His remarks were met with applause.

Like Scott, Melissa had been shocked to learn the prehospital blood he had received was not widely available to injured patients across the country.

“It doesn’t seem fair,” she said. “It doesn’t seem right.”

For Scott, now 52, the idea that other patients might not get blood before they get to a hospital is unfathomable.

You cannot put a price on life, he said.

Image of two people in kitchen

Mussey and wife Melissa together prepared an early Thanksgiving dinner for their family in November 2021, just seven months after Mussey’s near-fatal accident at their Pleasanton home.

Jerry Lara / San Antonio Express-News