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Penetrating Chest Trauma

Jeff Brosius trauma-list@trauma.org
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.


Jeff Brosius
Paramedic, etc.
Atlanta, GA
"...deliver them that are drawn unto death."
Proverbs 24:11 (NIV)