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Consider this Case Study

trauma-list@trauma.org trauma-list@trauma.org
Wed, 5 Jun 2002 21:22:55 EDT


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In a message dated 6/5/2002 7:28:33 PM Eastern Standard Time, 
dinerman@computron.net writes:


> Since the Pt was transferred to definitive care, and the fracture 
> successfully reduced with circulation restored, I feel the man was properly 
> treated.  But if what you say is true, could I be held criminally or 
> civilly liable for the use of a non-invasive tertiary examination 
> instrument, even if the treatment works to the favor of the Patient?  I 
> decided that the local ER was ill equipped for open reductions and vascular 
> surgery, and the ER Doc was in agreement.  
> 

Terry--
No, this is not what I said--read what was written, not what you want to 
see..IF you missed a vascualr injury based on your incorrect assessment of 
Doppler signals, you could be liable--I said--you lucked out here.  In the 
end, in fact, your assessment of a warm hand with flow did lead to the 
correct assessment of not that great an urgency, and you did realize the need 
for definitive care--no problem there.  You just need to realize the Doppler 
did not add to that--you're seeing it as too much of a crutch--learn to trust 
what you see and feel more, without feeling like you need a positive test to 
give you permission to make a clinical decision, and you will, as I said, be 
ahead of many physicians of the "modern" age
Try Dennis et al, J Trauma Feb 1998, Frykberg ER, Surgical Clinics of North 
America, April 1995.
ERF

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<HTML><FONT FACE=arial,helvetica><FONT  SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="0">In a message dated 6/5/2002 7:28:33 PM Eastern Standard Time, dinerman@computron.net writes:
<BR>
<BR>
<BR></FONT><FONT  COLOR="#000000" SIZE=2 FAMILY="SCRIPT" FACE="Comic Sans MS" LANG="0"><BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">Since the Pt was transferred to definitive care, and the fracture successfully reduced with circulation restored, I feel the man was properly treated. &nbsp;But if what you say is true, could I be held criminally or civilly liable for the use of a non-invasive tertiary examination instrument, even if the treatment works to the favor of the Patient? &nbsp;I decided that the local ER was ill equipped for open reductions and vascular surgery, and the ER Doc was in agreement. &nbsp;
<BR></BLOCKQUOTE>
<BR></FONT><FONT  COLOR="#000000" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="0">
<BR>Terry--
<BR>No, this is not what I said--read what was written, not what you want to see..IF you missed a vascualr injury based on your incorrect assessment of Doppler signals, you could be liable--I said--you lucked out here. &nbsp;In the end, in fact, your assessment of a warm hand with flow did lead to the correct assessment of not that great an urgency, and you did realize the need for definitive care--no problem there. &nbsp;You just need to realize the Doppler did not add to that--you're seeing it as too much of a crutch--learn to trust what you see and feel more, without feeling like you need a positive test to give you permission to make a clinical decision, and you will, as I said, be ahead of many physicians of the "modern" age
<BR>Try Dennis et al, J Trauma Feb 1998, Frykberg ER, Surgical Clinics of North America, April 1995.
<BR>ERF</FONT></HTML>

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