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Home > List Archives

Penetrating Chest Trauma

Bjorn, Pret trauma-list@trauma.org
Mon, 28 Apr 2003 09:51:04 -0400


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Jeff,
 
Beg to differ.  It's Monday, and I'm intolerant.
 
Destination decisions must be driven by adherence to protocol, not by any
given medic's education, experience or perceived situational awareness.  The
capability and capacity of any given trauma system hospital cannot be left
for each prehospital provider to reckon.  This is not a time to reflect what
one thinks is best; it's a time to look at the protocol and do what it says.
Assuming, of course, that Lafayette's protocol coincides with Andrew's
opinion...
 
Someone in authority must determine whether this was a misunderstanding or a
violation.  If a Bowmanesque protocol is in the books, then the medics broke
it, and their actions should be recorded, with a plan to remediate and
monitor them.  That's where the positive, constructive, self-affirming
phototropism comes into play.  
 
But unless he works from the framework of local rules, then Andrew's advice
will merely be digested along with all the other opinions and folklore in
the community, and the system will decay from lack of attention.
 
Pret
 
 
----Original Message-----
From: Jeff Brosius [  <mailto:medic245@mindspring.com>
mailto:medic245@mindspring.com]
Sent: Monday, April 28, 2003 8:05 AM
To: trauma-list@trauma.org
Subject: Re: Penetrating Chest Trauma

...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>
http://www.prehospitalperspective.com
"...deliver them that are drawn unto death."
Proverbs 24:11 (NIV)



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<DIV><FONT color=#800000 face=Arial size=2>Jeff,</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Beg to differ.&nbsp; It's Monday, and 
I'm intolerant.</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Destination decisions must be driven 
by adherence to protocol, not by any given medic's education, experience or 
perceived situational awareness.&nbsp; The capability and capacity of any given 
trauma system hospital cannot be left for each prehospital provider to 
reckon.&nbsp; This is not a time to reflect what one thinks is best; it's a time 
to look at the protocol and do what it says.&nbsp; </FONT><FONT color=#800000 
face=Arial size=2>Assuming, of course, that Lafayette's protocol coincides with 
Andrew's opinion...</FONT></DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Someone in authority must determine 
whether this was a misunderstanding or a violation.&nbsp; If a Bowmanesque 
protocol is in the books, then the medics broke it, and&nbsp;their actions 
should be recor</FONT><FONT color=#800000 face=Arial size=2>ded, with a plan to 
remediate and monitor them.&nbsp; That's where the positive, constructive, 
self-affirming phototropism comes into play.&nbsp; </FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>But unless he works from the 
framework of local rules, then Andrew's advice will merely be digested along 
with all the other opinions and folklore in the community, and the system will 
decay from lack of attention.</FONT></DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Pret</FONT></DIV>
<DIV>&nbsp;</DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><FONT color=#000000>----Original 
Message-----<BR>From: Jeff Brosius [</FONT></FONT><A 
href="mailto:medic245@mindspring.com"><FONT color=#000000 face=Arial 
size=2>mailto:medic245@mindspring.com</FONT></A><FONT face=Arial 
size=2>]<BR>Sent: Monday, April 28, 2003 8:05 AM<BR>To: 
trauma-list@trauma.org<BR>Subject: Re: Penetrating Chest Trauma<BR><BR>...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.&nbsp; Then request to be part of a review committee, 
such as Pret suggested.<BR><BR>Also, this situation tells me they have some 
SERIOUS problems in the CQI department.&nbsp; That will be much harder to fix, I 
think... and I'm not sure where you'd begin.<BR><BR>Not much help, I'm 
afraid.&nbsp; To me, it sounds like an educational 
issue.<BR><BR><BR>Best,<BR><BR>Jeff Brosius<BR>Paramedic, etc.<BR>Atlanta, 
GA<BR>brosius@prehospitalperspective.com<BR></FONT><A 
href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://www.prehospitalperspective.com" target=_blank><FONT color=#000000 
face=Arial size=2>http://www.prehospitalperspective.com</FONT></A><BR><FONT 
face=Arial size=2>"...deliver them that are drawn unto death."<BR>Proverbs 24:11 
(NIV)<BR><BR><BR><BR>--<BR>trauma-list : TRAUMA.ORG<BR>To change your settings 
or unsubscribe visit:<BR></FONT><A href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://www.trauma.org/traumalist.html" 
target=_blank><FONT color=#000000 face=Arial 
size=2>http://www.trauma.org/traumalist.html</FONT></A><BR></DIV></BODY></HTML>

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