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Penetrating Chest Trauma

trauma-list@trauma.org trauma-list@trauma.org
Tue, 29 Apr 2003 14:31:11 EDT


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In a message dated 4/29/2003 1:24:49 PM Central Daylight Time, 
sumieb@compuserve.com writes:

> 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".
> 

I am truly sorry that your surgeons are not committed to quality care for the 
patients that your serve.   Every document that I have read about systems 
approach to trauma care, mandates that the surgeon be involved at all levels. 
 The ACS requires that patients meeting your local trauma activation 
criteria, be present upon the patients arrival at the EC.    To want to be 
called AFTER CTs are performed is simply to not understand the problem.   I 
do not know what community you represent, but I also now know what community 
I do not want to be traumatized in.    Thanks for sharing some of the issues 
which beg for a trauma system  solution.  

k

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<HTML><FONT FACE=3Darial,helvetica><FONT  SIZE=3D2 FAMILY=3D"SANSSERIF" FACE=
=3D"Arial" LANG=3D"0">In a message dated 4/29/2003 1:24:49 PM Central Daylig=
ht Time, sumieb@compuserve.com writes:<BR>
<BR>
<BLOCKQUOTE TYPE=3DCITE style=3D"BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT=
: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px"></FONT><FONT  COLOR=3D"#000000"=
 style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2 FAMILY=3D"SANSSERIF" FACE=3D"T=
ahoma" LANG=3D"0"><B>Surgeons have little to no involvement in pre-hospital/=
ER trauma decisions (by their own decision).&nbsp; Several years ago when I=20=
was in the beginnings of developing a "Trauma Team" for our ED the surgeons=20=
were invited to the proceedings from the very beginning.&nbsp; They (as a gr=
oup) left it to the ED to plan and implement.</FONT><FONT  COLOR=3D"#000000"=
 style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D3 FAMILY=3D"SANSSERIF" FACE=3D"A=
rial" LANG=3D"0"></B><BR>
&nbsp; <BR>
</FONT><FONT  COLOR=3D"#000000" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2=
 FAMILY=3D"SANSSERIF" FACE=3D"Tahoma" LANG=3D"0"><B>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).&nbsp; 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=
".</FONT><FONT  COLOR=3D"#000000" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=
=3D3 FAMILY=3D"SANSSERIF" FACE=3D"Arial" LANG=3D"0"></B><BR>
</BLOCKQUOTE><BR>
</FONT><FONT  COLOR=3D"#000000" style=3D"BACKGROUND-COLOR: #ffffff" SIZE=3D2=
 FAMILY=3D"SANSSERIF" FACE=3D"Arial" LANG=3D"0"><BR>
I am truly sorry that your surgeons are not committed to quality care for th=
e patients that your serve.&nbsp;&nbsp; Every document that I have read abou=
t systems approach to trauma care, mandates that the surgeon be involved at=20=
all levels.&nbsp; The ACS requires that patients meeting your local trauma a=
ctivation criteria, be present upon the patients arrival at the EC.&nbsp;&nb=
sp;&nbsp; To want to be called AFTER CTs are performed is simply to not unde=
rstand the problem.&nbsp;&nbsp; I do not know what community you represent,=20=
but I also now know what community I do not want to be traumatized in.&nbsp;=
&nbsp;&nbsp; Thanks for sharing some of the issues which beg for a trauma sy=
stem&nbsp; solution.&nbsp; <BR>
<BR>
k</FONT></HTML>

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