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Home > List Archives

Penetrating Chest Trauma

Andrew J Bowman trauma-list@trauma.org
Tue, 29 Apr 2003 13:02:10 -0500


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Surgeons have little to no involvement in pre-hospital/ER trauma =
decisions (by their own decision).  Several years ago when I was in the =
beginnings of developing a "Trauma Team" for our ED the surgeons were =
invited to the proceedings from the very beginning.  They (as a group) =
left it to the ED to plan and implement.

Even now, their approach is for ED physician stabilization and call when =
the CT is ready (for stable patients) and come in quickly when called =
for unstable (with many, not all, grumbling about it).  Very few times =
has a surgeon come in when called by the EDP based on EMS report, "Call =
me when he gets there and you see him".

Of course when the surgeon does get to the ED it is usually "Hurry, =
hurry, hurry"  Yeah, we know, that is why we called you!

Sorry for the venting, it is just frustrating to be passionate about =
trauma care and not be supported by the community I work in!

Andrew Bowman
  ----- Original Message -----=20
  From: KMATTOX@aol.com=20
  To: trauma-list@trauma.org=20
  Sent: Tuesday, April 29, 2003 12:21 PM
  Subject: Re: Penetrating Chest Trauma


  In a message dated 4/29/2003 11:29:53 AM Central Daylight Time, =
sumieb@compuserve.com writes:


    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".



  Where are the surgeons and the trauma services and  the trauma  =
programs of these two hospitals.  The trauma programs must transcend =
individual ER physicians, but must reflect the  committment of the  =
entire enterprise. =20

  k=20

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<BODY bgColor=3D#ffffff>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Surgeons have little to no =
involvement in=20
pre-hospital/ER trauma decisions (by their own decision).&nbsp; Several =
years=20
ago when I was in the beginnings of developing a "Trauma Team" for our =
ED the=20
surgeons were invited to the proceedings from the very beginning.&nbsp; =
They (as=20
a group) left it to the ED to plan and implement.</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Even now, their approach is =
for ED=20
physician stabilization and call when the CT is ready (for stable =
patients) and=20
come in quickly when called for unstable (with many, not all, grumbling =
about=20
it).&nbsp; Very few times has a surgeon come in when called by the EDP =
based on=20
EMS report, "Call me when he gets there and you see =
him".</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Of course when the surgeon =
does get to the=20
ED it is usually "Hurry, hurry, hurry"&nbsp; Yeah, we know, that is why =
we=20
called you!</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Sorry for the venting, it is =
just=20
frustrating to be passionate about trauma care and not be supported by =
the=20
community I work in!</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Andrew =
Bowman</FONT></STRONG></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=3DKMATTOX@aol.com =
href=3D"mailto:KMATTOX@aol.com">KMATTOX@aol.com</A>=20
  </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> Tuesday, April 29, 2003 =
12:21=20
  PM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: Penetrating Chest=20
  Trauma</DIV>
  <DIV><BR></DIV><FONT face=3Darial,helvetica><FONT lang=3D0 =
face=3DArial size=3D2=20
  FAMILY=3D"SANSSERIF">In a message dated 4/29/2003 11:29:53 AM Central =
Daylight=20
  Time, <A =
href=3D"mailto:sumieb@compuserve.com">sumieb@compuserve.com</A>=20
  writes:<BR><BR>
  <BLOCKQUOTE=20
  style=3D"PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #0000ff 2px =
solid; MARGIN-RIGHT: 0px"=20
  TYPE=3D"CITE">What I have seen over the past 20 years of EMS/ED =
practice in=20
    this community<BR>is that there are 2 groups of ED physicians (1 at =
each=20
    ED).&nbsp; One group says<BR>to the medics "Do what you want, we =
will sign=20
    off on it"&nbsp; the other group<BR>says "Follow your protocol and =
call in=20
    if you feel there is a need to<BR>deviate from it".&nbsp; Who do you =
think=20
    the medics like best?&nbsp; Does this make<BR>one group of ED docs=20
    better?&nbsp; No, both groups are full board certified EM<BR>(most =
from same=20
    teaching institution) but it gives the medics an idea as to<BR>who =
is "fun"=20
    and who is "not fun".<BR></BLOCKQUOTE><BR><BR>Where are the surgeons =
and the=20
  trauma services and&nbsp; the trauma&nbsp; programs of these two=20
  hospitals.&nbsp; The trauma programs must transcend individual ER =
physicians,=20
  but must reflect the&nbsp; committment of the&nbsp; entire =
enterprise.&nbsp;=20
  <BR><BR>k</FONT> </FONT></BLOCKQUOTE></BODY></HTML>

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