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Before they landed, the crew of the chopper from Baptist Hospital saw the shark on the beach, its gray body against the white sand. Once the chopper touched down, they discovered that Jessie had basically been drained of blood, the worst situation in a trauma. In such situations, fewer than 1% of victims survive. No medication can help the heart. "There is nothing left to pump," says Greg Smith, an emergency-room physician who had hopped onto the helicopter when he heard there had been a shark attack. "You've basically run the pump dry." The medics could well have declared Jessie dead. But Smith and paramedic Chris Warnock had kept the chopper's engines running for a "scoop and run" and with Jessie's uncle, they carried the boy to the chopper. "He was kind of like a rag doll," Smith says. Inside, the medics continued CPR and inserted a breathing tube. They had been on the ground less than 6 min. As they closed the door, they asked about the arm. Smith says, "No one knew where it was."
The shark was still thrashing on the beach. Jared Klein, a National Park Service ranger, wondered whether the arm was in the water or in the shark's mouth. At a paramedic's suggestion, he took his expandable baton and pried apart the bull shark's jaws. There it was. But, says Klein, "the arm was too far in the mouth to remove it," particularly with the shark still in violent convulsion. He asked the crowd to step back and shot the shark four times in the head. Then he opened its mouth with the baton, while Tony Thomas, a lifeguard and volunteer firefighter, his own arm wrapped in a towel for protection, reached in with hemostats and extracted the limb. He covered it with a towel and packed it in ice to be rushed to a waiting ambulance.
By the time the chopper landed at the hospital, Jessie had gone without blood--and thus oxygen--for 30 min. The medics put him on a gurney and took him down in an elevator four floors to Trauma Room 9, continuing CPR all the way. As doctors, nurses, aides and technicians hunched over the lifeless boy, nurse Dawn Colbert inserted an IV into his arm and began a rapid infusion of O-negative blood, the universal-donor type. Within 15 minutes, Colbert pumped nearly 1.5 liters of warmed blood into Jessie, about half the normal volume for an 80-lb. boy. Jessie began to bleed. But his heart still wasn't beating on its own. Twice the team stopped CPR, waiting for Jessie's heart to pump on its own. No pulse. Nurse Sandi Miller, who was keeping watch for the arrival of the arm, prayed under her breath as the team continued CPR, then paused for a third time. One doctor felt a faint carotid pulse, another felt a femoral pulse. The blood began to flow on its own. Outside, the ambulance had pulled up. "As soon as his limb came through the door, we got a heartbeat," Miller says.
Having stabilized Jessie, Dr. Jack Tyson summoned colleagues to close up the wound. Joining Tyson in the E.R. were orthopedic surgeon Juliet De Campos and microvascular surgeon Ian Rogers. The doctors were surprised by the neat tears in the muscles and tissues. "My God," Rogers told the others. "This is replantable!" In 16 years of reattaching arms, it was the cleanest cut Rogers had ever seen. "You never get a shark bite like that," says De Campos. Still, the doctors debated for nearly an hour before Rogers made the call to proceed.