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Consider this Case Study

Terry Dinerman trauma-list@trauma.org
Fri, 7 Jun 2002 11:20:56 -0700


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Ms. Owens-

Don't pester the Doc..... a good lesson for an older student generally =
starts with having to abandon a formerly closely held doctrine.

Just cause Doc doesn't exactly give me a hug before he illuminates his =
point doesn't mean his point is no less valid.

I used to think MAST was the cats pajamas as well till someone broke =
that bubble.

Doc can kick my rump any day.  Must have been a Gunnery Sergeant in a =
former life........

Regards-

Terry Dinerman EMTP
  ----- Original Message -----=20
  From: Owens, Patricia=20
  To: 'trauma-list@trauma.org'=20
  Sent: Wednesday, June 05, 2002 8:17 PM
  Subject: RE: Consider this Case Study


  Isn't there a way of teaching in a less threatening way?=20

  Patricia J. Owens, RN,BSN
  Trauma Team Leader - MOR
  6-8910

  > -----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
  >=20
  > hey, not so aggressive with the derision=20
  >=20
  > stephanie stafford=20
  >=20
  >   DocRickFry@aol.com wrote:=20
  >=20
  >=20
  > 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
  >=20
  >=20
  > --
  > trauma-list : TRAUMA.ORG
  > To change your settings or unsubscribe visit:
  > http://www.trauma.org/traumalist.html
  >=20
  >=20
  >=20
  >   _____ =20
  >=20
  > Do You Yahoo!?
  > Sign-up for Video Highlights
  > =
<http://rd.yahoo.com/welcome/*http://fifaworldcup.yahoo.com/fc/en/spl> =
of 2002
  > FIFA World Cup

  --
  trauma-list : TRAUMA.ORG
  To change your settings or unsubscribe visit:
  http://www.trauma.org/traumalist.html



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<DIV><FONT face=3D"Comic Sans MS">Ms. Owens-</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">Don't pester the Doc..... a good =
lesson for an=20
older student&nbsp;generally starts with having to abandon a formerly =
closely=20
held doctrine.</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">Just cause Doc doesn't exactly give me =
a hug=20
before he illuminates his point doesn't mean his point is no less=20
valid.</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">I used to think MAST was the =
cats&nbsp;pajamas=20
as well till someone broke that bubble.</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">Doc can kick my rump any day.&nbsp; =
Must have=20
been a Gunnery Sergeant in a former life........</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">Regards-</FONT></DIV>
<DIV><FONT face=3D"Comic Sans MS"></FONT>&nbsp;</DIV>
<DIV><FONT face=3D"Comic Sans MS">Terry Dinerman EMTP</FONT></DIV>
<BLOCKQUOTE=20
style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
  <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
  <DIV=20
  style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
  <A title=3DPOWENS@PARTNERS.ORG =
href=3D"mailto:POWENS@PARTNERS.ORG">Owens,=20
  Patricia</A> </DIV>
  <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
  href=3D"mailto:'trauma-list@trauma.org'">'trauma-list@trauma.org'</A> =
</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Wednesday, June 05, 2002 =
8:17=20
  PM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> RE: Consider this Case =

  Study</DIV>
  <DIV><BR></DIV>Isn't there a way of teaching in a less threatening =
way?=20
  <BR><BR>Patricia J. Owens, RN,BSN<BR>Trauma Team Leader -=20
  MOR<BR>6-8910<BR><BR>&gt; -----Original Message-----<BR>&gt; From: =
stephanie=20
  staford [SMTP:sstafford1168@yahoo.com]<BR>&gt; Sent: Wednesday, June =
05, 2002=20
  6:36 PM<BR>&gt; To: <A=20
  =
href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A><BR>&gt;=
=20
  Subject: Re: Consider this Case Study<BR>&gt; <BR>&gt; hey, not so =
aggressive=20
  with the derision <BR>&gt; <BR>&gt; stephanie stafford <BR>&gt;=20
  <BR>&gt;&nbsp;&nbsp; <A=20
  href=3D"mailto:DocRickFry@aol.com">DocRickFry@aol.com</A> wrote: =
<BR>&gt;=20
  <BR>&gt; <BR>&gt; Terry Dinerman--<BR>&gt; Shades of MAST trousers and =
spinal=20
  steroids!<BR>&gt; Whoa just one minute.<BR>&gt; You should become at =
least=20
  passing acquainted with the literature on<BR>&gt; Dopplers in =
assessing for=20
  extrremity vascular injury--you have a serious<BR>&gt; =
misunderstanding of its=20
  proven value and role! Please let me know if you would<BR>&gt; like =
any of the=20
  volumes of refs on this?<BR>&gt; It may interest you to know that =
Doppler flow=20
  does not at all exclude a<BR>&gt; vascular injury in an injured=20
  extremity--apparently you are under the<BR>&gt; misapprehension that =
it does.=20
  Did you realize that Doppler flow can be present<BR>&gt; distal to a=20
  completely transected or occluded vessel? Collaterals will be<BR>&gt; =
picked=20
  up by Doppler--but an absent pulse is a known hard sign of =
vascular<BR>&gt;=20
  injury that is well established as highly accurate--its absence in=20
  itself<BR>&gt; mandates immediate evaluation--following blunt trauma =
by=20
  arteriogram,<BR>&gt; follwoing penetrating trauma by direct operation. =
This is=20
  again old and well<BR>&gt; established data. The fact you appear to =
have=20
  gotten away with it in this<BR>&gt; presented case should NOT =
positively=20
  reinforce you--the simple phys exam is<BR>&gt; superior to any =
noninvasive=20
  testing for this purpose--and noninvasives have<BR>&gt; never yet been =
shown=20
  to have any benefit over and above the phys presence or<BR>&gt; =
absence of=20
  hard signs (absent pulse being only one of the five hard =
signs).<BR>&gt; Don;t=20
  waste your money on these devices--and please, don't endanger =
your<BR>&gt;=20
  license by using it with your present level of understanding of its=20
  validity.<BR>&gt; As an expert witness, I would do you in....<BR>&gt;=20
  ERF<BR>&gt; <BR>&gt; <BR>&gt; --<BR>&gt; trauma-list : =
TRAUMA.ORG<BR>&gt; To=20
  change your settings or unsubscribe visit:<BR>&gt; <A=20
  =
href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002-June/3D"http://www.trauma.org/traumalist.html">http://www.trauma.org/trau=
malist.html</A><BR>&gt;=20
  <BR>&gt; <BR>&gt; <BR>&gt;&nbsp;&nbsp; _____&nbsp; <BR>&gt; <BR>&gt; =
Do You=20
  Yahoo!?<BR>&gt; Sign-up for Video Highlights<BR>&gt; &lt;<A=20
  =
href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002-June/3D"http://rd.yahoo.com/welcome/*http://fifaworldcup.yahoo.com/fc/en/=
spl">http://rd.yahoo.com/welcome/*http://fifaworldcup.yahoo.com/fc/en/spl=
</A>&gt;=20
  of 2002<BR>&gt; FIFA World Cup<BR><BR>--<BR>trauma-list : =
TRAUMA.ORG<BR>To=20
  change your settings or unsubscribe visit:<BR><A=20
  =
href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002-June/3D"http://www.trauma.org/traumalist.html">http://www.trauma.org/trau=
malist.html</A><BR><BR></BLOCKQUOTE></BODY></HTML>

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