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Consider this Case Study

Owens, Patricia trauma-list@trauma.org
Wed, 5 Jun 2002 23:17:04 -0400

Isn't there a way of teaching in a less threatening way? 

Patricia J. Owens, RN,BSN
Trauma Team Leader - MOR

> -----Original Message-----
> From:	stephanie staford [SMTP:sstafford1168@yahoo.com]
> Sent:	Wednesday, June 05, 2002 6:36 PM
> To:	trauma-list@trauma.org
> Subject:	Re: Consider this Case Study
> hey, not so aggressive with the derision 
> stephanie stafford 
>   DocRickFry@aol.com wrote: 
> 	Terry Dinerman--
> 	Shades of MAST trousers and spinal steroids!
> 	Whoa just one minute.
> 	You should become at least passing acquainted with the literature on
> Dopplers in assessing for extrremity vascular injury--you have a serious
> misunderstanding of its proven value and role! Please let me know if you would
> like any of the volumes of refs on this?
> 	It may interest you to know that Doppler flow does not at all exclude a
> vascular injury in an injured extremity--apparently you are under the
> misapprehension that it does. Did you realize that Doppler flow can be present
> distal to a completely transected or occluded vessel? Collaterals will be
> picked up by Doppler--but an absent pulse is a known hard sign of vascular
> injury that is well established as highly accurate--its absence in itself
> mandates immediate evaluation--following blunt trauma by arteriogram,
> follwoing penetrating trauma by direct operation. This is again old and well
> established data. The fact you appear to have gotten away with it in this
> presented case should NOT positively reinforce you--the simple phys exam is
> superior to any noninvasive testing for this purpose--and noninvasives have
> never yet been shown to have any benefit over and above the phys presence or
> absence of hard signs (absent pulse being only one of the five hard signs).
> Don;t waste your money on these devices--and please, don't endanger your
> license by using it with your present level of understanding of its validity.
> As an expert witness, I would do you in....
> 	ERF
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