# A Case of Polytrauma in a Farmer Following a Cow Attack: "Code Farmer"

## TL;DR

A farmer suffered severe injuries from a cow attack but initially reported only shortness of breath, highlighting the need for careful evaluation of farmers in emergencies.

## Contribution

Introduces the term 'code farmer' to emphasize the hidden severity of injuries in farmers due to their occupational resilience and delayed medical attention.

## Key findings

- Farmers may present with minor complaints that mask serious injuries due to high pain tolerance and occupational risks.
- A cow attack caused polytrauma in a farmer, requiring ICU admission and multidisciplinary care despite an initially subtle presentation.

## Abstract

This case involves a farmer who presented to a level 1 trauma center following an attack by a cow. It highlights the emerging use of the term “code farmer” among emergency department physicians and nurses, a colloquial alert reflecting the concern that farmers may present with seemingly minor complaints that often mask more serious or insidious underlying injuries or health conditions.

The phrase “code farmer" is an emerging term gaining traction among emergency medicine physicians and nurses. It reflects a recognition that farmers often endure strenuous work environments, long hours, and a high pain tolerance, making them less likely to seek medical attention unless faced with injuries or pathologies that demand urgent and serious intervention. Farmers are routinely exposed to significant occupational hazards, including chemical, environmental, mechanical, and livestock-related risks, and chronic health challenges.

This case exemplifies the occupational risks faced by farmers. It describes a patient who sustained polytrauma involving the face, thorax, and abdomen, including multiple solid organ injuries following a cow attack. Despite the severity of his condition, his initial chief complaint was simply shortness of breath. He ultimately required intensive care unit (ICU) admission and multidisciplinary medical and surgical management.