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Penetrating Chest Trauma

Andrew J Bowman trauma-list@trauma.org
Tue, 29 Apr 2003 11:20:09 -0500

What I have seen over the past 20 years of EMS/ED practice in this community
is that there are 2 groups of ED physicians (1 at each ED).  One group says
to the medics "Do what you want, we will sign off on it"  the other group
says "Follow your protocol and call in if you feel there is a need to
deviate from it".  Who do you think the medics like best?  Does this make
one group of ED docs better?  No, both groups are full board certified EM
(most from same teaching institution) but it gives the medics an idea as to
who is "fun" and who is "not fun".

And no this is not the first occurrence of protocol deviation, it is an
often repeated event and not just with patient transport but also in

Scary sometimes.

Andrew Bowman

----- Original Message -----
From: <htaed_rd@123mail.org>
To: "trauma-list" <trauma-list@trauma.org>
Sent: Tuesday, April 29, 2003 10:35 AM
Subject: RE: Penetrating Chest Trauma

> Happy Tuesday!
> How often does this occur? If this is a frequent occurrence the problem
> might not be this particular case, but the attitude of the medics toward
> the rules. Rules not enforced, but broken regularly are not going to be
> heeded by anyone.
> I have worked many places where the attitude of the medics is that one of
> the local hospitals provides "inadequate" care (usually expressed more
> colorfully than that). This "inadequate" hospital may also receive many
> intoxicated patients from areas that are closer to other hospitals.
> You might want to ask some of the medics if this is contributing to
> the problem.
> Education is important. If they misunderstand the risks involved the
> medics are unlikely to make good decisions.
> Tim Noonan.