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Mon, 28 Apr 2003 08:04:59 -0400

At 10:59 PM 4/27/2003 -0500, you wrote:
>Friday night, GSW to the chest, unstable and near arrest in the 
>field.  medics drove right past the non bypass hospital to get to the 
>hospital with bypass.  Patient died in the ER shortly after arrival.  (by 
>the way, at 12 midnight, the cardiac suite is closed!)
>
>I have talked with EMS and their director until blue in face that there is 
>no evidence that support driving past 1 ER to another just for the sake of 
>"maybe" needing bypass (big maybe).  Most (far and away most) trauma 
>patients will not need bypass and patient may die getting to the other place.
>
>Any suggestions for how to proceed?????
>
>Andrew J. Bowman, RN, CEN, CCRN, NREMT-P

Find out WHY the medics think that bypass will be needed for thoracic 
trauma patients... teach them the truth, in a constructive, positive 
manner, and offer to help them see the light.  Then request to be part of a 
review committee, such as Pret suggested.

Also, this situation tells me they have some SERIOUS problems in the CQI 
department.  That will be much harder to fix, I think... and I'm not sure 
where you'd begin.

Not much help, I'm afraid.  To me, it sounds like an educational issue.

Best,

Jeff Brosius
Paramedic, etc.
Atlanta, GA
brosius@prehospitalperspective.com
http://www.prehospitalperspective.com
"...deliver them that are drawn unto death."
Proverbs 24:11 (NIV)

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