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Bjorn, Pret trauma-list@trauma.orgWed, 30 Apr 2003 10:01:30 -0400
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This message is in MIME format. Since your mail reader does not understand this format, some or all of this message may not be legible. ------_=_NextPart_000_01C30F20.FFE47C00 Content-Type: multipart/alternative; boundary="----_=_NextPart_001_01C30F20.FFE47C00" ------_=_NextPart_001_01C30F20.FFE47C00 Content-Type: text/plain; charset="windows-1252" Dr. Zidan, At least where these topics are concerned, I think ATLS aligns with the available evidence. Most of the controversy I've encountered relates to conventional practices, which have to one degree or another failed to keep up with either ATLS or contemporary evidence. I've quoted directly from the current ATLS text below. If I missed something, perhaps you'll elaborate. All best, Pret Bjorn Trauma Coordinator EMMC Trauma Program 489 State Street Bangor, ME 04401 207.973.7260 (office) 207.973.7673 (fax) 207.941.5085 (voice pager) -----Original Message----- From: alaa [mailto:coolzizo@hotmail.com] Sent: Wednesday, April 30, 2003 9:14 AM To: trauma-list@trauma.org; trauma-list@trauma.org Subject: Re: ATLS THE ISSUE OF C-SPINE CLEARANCE ATLS: "As long as the patient's spine is protected, evaluation of the spine and exclusion of spine injury may be safely deferred, especially in the presence of systemic instability." THE ISSUE OF DPL VERSUS ULTRASOUND ATLS: "Ultrasound has a sensitivity, specificity, and accuracy comparable to diagnostic peritoneal lavage and abdominal computed axial tomography in experienced hands." THE ISSUE OF HYPERVENTILATION IN HEAD TRAUMA ATLS: "Hyperventilation may be used cautiously in patients who demonstrate [GCS 3-8 and] worsening GCS or pupillary dilitation. The PCO2 should be kept between 25 and 35 mm Hg." I think we can start a debate in the list , for further updating ourselves , and enriching our experience by learning from each other I do indeed plea for a stimulating discussion in this list Dr. Alaa Zidan Orthopaedic surgeon &Team leader Accident&Emergency dept. Salmanyia medical complex.P.O Box 12 Manama, Kingdom of Bahrain -------Original Message------- From: trauma-list@trauma.org <mailto:trauma-list@trauma.org> Date: Wednesday, April 30, 2003 10:10:37 To: trauma-list@trauma.org <mailto:trauma-list@trauma.org> Subject: Re: ATLS 99% of ATLS is middle of the road. Good safe medicine. do you have any specific issues? E Errington C. Thompson, MD, FACS Trauma Surgeon Trinity Mother Frances Tyler, Tx. ecthompson@tyler.net <mailto:ecthompson@tyler.net> Don't think you are Know you are - Morpheus (The Matrix) ----- Original Message ----- From: alaa <mailto:coolzizo@hotmail.com> To: trauma-list@trauma.org <mailto:trauma-list@trauma.org> Sent: Tuesday, April 29, 2003 10:29 AM Subject: Fw: ATLS -------Original Message------- From: alaa <mailto:coolzizo@hotmail.com> Date: Sunday, April 27, 2003 11:30:39 To: trauma-list@trauma.org <mailto:trauma-list@trauma.org> Subject: ATLS Dear Trauma list members I would be grateful if some one can elaborate on the different issues in ATLS which are of debate and contraversy Best regards DR Alaa zidan SMC, Bahrain ____________________________________________________ <http://www.incredimail.com/redir.asp?ad_id=309&lang=9> IncrediMail - Email has finally evolved - <http://www.incredimail.com/redir.asp?ad_id=309&lang=9> Click Here ------_=_NextPart_001_01C30F20.FFE47C00 Content-Type: text/html; charset="windows-1252" <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <HTML xmlns:v xmlns:o><HEAD> <META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=windows-1252"> <META content="MSHTML 5.00.2919.6307" name=GENERATOR><!--IncrdiXMLRemarkStart> <IncrdiX-Info> <X-FID>FLAVOR00-NONE-0000-0000-000000000000</X-FID> <X-FVER></X-FVER> <X-CNT>;</X-CNT> </IncrdiX-Info> <IncrdiXMLRemarkEnd--></HEAD> <BODY background="" bgColor=#ffffff scroll=yes style="BACKGROUND-POSITION: 0px 0px; FONT-FAMILY: Arial; FONT-SIZE: 12pt; MARGIN: 5px 10px 10px" X-FVER="3.0" ORGYPOS="0"> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>Dr. Zidan,</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003></SPAN></FONT> </DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>At least where these topics are concerned, I think ATLS aligns with the available evidence. Most of the controversy I've encountered relates to conventional practices, which have to one degree or another failed to keep up with either ATLS <EM>or </EM>contemporary evidence.</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003></SPAN></FONT> </DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>I've quoted directly from the current ATLS text below. If I missed something, perhaps you'll elaborate.</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003></SPAN></FONT> </DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>All best, </SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003></SPAN></FONT> </DIV> <DIV><SPAN class=580143213-30042003> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>Pret Bjorn</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>Trauma Coordinator</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>EMMC Trauma Program</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>489 State Street</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>Bangor, ME 04401</SPAN></FONT></DIV> <DIV><SPAN class=030133519-19052000></SPAN><FONT color=#800000 size=2> </FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>207.973.7260 (office)</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>207.973.7673 (fax)</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=030133519-19052000>207.941.5085 (voice pager)</SPAN></FONT></DIV> <DIV><SPAN class=030133519-19052000></SPAN><FONT size=2><FONT color=#800000> <SPAN class=580143213-30042003> </SPAN></FONT></FONT></DIV> <BLOCKQUOTE style="MARGIN-RIGHT: 0px"> <DIV><FONT size=2><FONT color=#800000><SPAN class=580143213-30042003> </SPAN></FONT></FONT></SPAN><FONT face=Tahoma><FONT size=2>-----Original Message-----<BR><B>From:</B> alaa [mailto:coolzizo@hotmail.com]<BR><B>Sent:</B> Wednesday, April 30, 2003 9:14 AM<BR><B>To:</B> trauma-list@trauma.org; trauma-list@trauma.org<BR><B>Subject:</B> Re: ATLS</DIV></BLOCKQUOTE></FONT></DIV> <BLOCKQUOTE></FONT> <TABLE border=0 cellPadding=2 cellSpacing=0 id=INCREDIMAINTABLE width="100%"><TBODY> <TR> <TD id=INCREDITEXTREGION style="CURSOR: auto; FONT-FAMILY: Arial; FONT-SIZE: 12pt" width="100%"> <DIV>THE ISSUE OF C-SPINE CLEAR<SPAN class=580143213-30042003><FONT color=#800000 size=2><FONT color=#000000 size=3>A</FONT></FONT></SPAN>NCE<FONT color=#800000 size=2><SPAN class=580143213-30042003> </SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>ATLS:</SPAN></FONT><FONT color=#800000 size=2><SPAN class=580143213-30042003> "<EM>As long as the patient's spine is protected, evaluation of the spine and exclusion of spine injury may be safely deferred, especially in the presence of systemic instability</EM>." </SPAN></FONT></DIV> <DIV><SPAN class=580143213-30042003><FONT color=#800000 size=2> </FONT></SPAN></DIV> <DIV>THE ISSUE OF DPL VERSUS ULTRASOUND<FONT color=#800000 size=2><SPAN class=580143213-30042003> </SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>ATLS: "<EM>Ultrasound has a sensitivity, specificity, and accuracy comparable to diagnostic peritoneal lavage and abdominal computed axial tomography in experienced hands</EM>."</SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003> </SPAN></FONT></DIV> <DIV>THE ISSUE OF HYPERVENTILATION IN HEAD TRAUMA<FONT color=#800000 size=2><SPAN class=580143213-30042003> </SPAN></FONT></DIV> <DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>ATLS: "<EM>Hyperventilation may be used cautiously in patients who demonstrate [GCS 3-8 and] worsening GCS or pupillary dilitation. The PCO2 should be kept between 25 and 35 mm Hg</EM>." </SPAN></FONT></DIV> <DIV> </DIV> <DIV>I think we can start a debate in the list , for further updating ourselves , and enriching our experience by learning from each other</DIV> <DIV> </DIV> <DIV>I do indeed plea for a stimulating discussion in this list</DIV> <DIV> </DIV> <DIV> </DIV> <DIV>Dr. Alaa Zidan</DIV> <DIV>Orthopaedic surgeon &Team leader</DIV> <DIV>Accident&Emergency dept.</DIV> <DIV>Salmanyia medical complex.P.O Box 12</DIV> <DIV>Manama, Kingdom of Bahrain</DIV> <DIV> </DIV> <DIV id=IncrediOriginalMessage><I>-------Original Message-------</I></DIV> <DIV> </DIV> <DIV id=receivestrings> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>From:</B></I> <A href="mailto:trauma-list@trauma.org">trauma-list@trauma.org</A></DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>Date:</B></I> Wednesday, April 30, 2003 10:10:37</DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>To:</B></I> <A href="mailto:trauma-list@trauma.org">trauma-list@trauma.org</A></DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>Subject:</B></I> Re: ATLS</DIV></DIV> <DIV> </DIV> <DIV>99% of ATLS is middle of the road. Good safe medicine. do you have any specific issues?</DIV> <DIV> </DIV> <DIV>E</DIV> <DIV> </DIV> <DIV>Errington C. Thompson, MD, FACS<BR>Trauma Surgeon<BR>Trinity Mother Frances<BR>Tyler, Tx.<BR><A href="mailto:ecthompson@tyler.net">ecthompson@tyler.net</A></DIV> <DIV> </DIV> <DIV>Don't think you are<BR>Know you are<BR> <BR> - Morpheus (The Matrix)<BR></DIV> <BLOCKQUOTE dir=ltr style="BORDER-LEFT: #000000 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px"> <DIV style="FONT: 10pt arial">----- Original Message ----- </DIV> <DIV style="FONT: 10pt arial"><B>From:</B> <A href="mailto:coolzizo@hotmail.com" title=coolzizo@hotmail.com>alaa</A> </DIV> <DIV style="FONT: 10pt arial"><B>To:</B> <A href="mailto:trauma-list@trauma.org" title=trauma-list@trauma.org>trauma-list@trauma.org</A> </DIV> <DIV style="FONT: 10pt arial"><B>Sent:</B> Tuesday, April 29, 2003 10:29 AM</DIV> <DIV style="FONT: 10pt arial"><B>Subject:</B> Fw: ATLS</DIV> <DIV><BR></DIV> <DIV style="FONT-FAMILY: Arial; FONT-SIZE: 12pt"> <TABLE border=0 cellPadding=2 cellSpacing=0 id=rem_INCREDIMAINTABLE width="100%"> <TBODY> <TR> <TD id=rem_INCREDITEXTREGION style="CURSOR: auto; FONT-FAMILY: Arial; FONT-SIZE: 12pt" width="100%"> <DIV> </DIV> <DIV> </DIV> <DIV id=IncrediOriginalMessage><I>-------Original Message-------</I></DIV> <DIV> </DIV> <DIV id=receivestrings> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>From:</B></I> <A href="mailto:coolzizo@hotmail.com">alaa</A></DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>Date:</B></I> Sunday, April 27, 2003 11:30:39</DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>To:</B></I> <A href="mailto:trauma-list@trauma.org">trauma-list@trauma.org</A></DIV> <DIV dir=ltr style="FONT-SIZE: 11pt" <i><B>Subject:</B></I> ATLS</DIV></DIV> <DIV> </DIV> <DIV>Dear Trauma list members </DIV> <DIV> </DIV> <DIV>I would be grateful if some one can elaborate on the different issues in ATLS which are of debate and contraversy</DIV> <DIV> </DIV> <DIV>Best regards</DIV> <DIV> </DIV> <DIV>DR Alaa zidan</DIV> <DIV>SMC, Bahrain</DIV></TD></TR> <TR> <TD id=rem_INCREDIFOOTER width="100%"> <TABLE cellPadding=0 cellSpacing=0 width="100%"> <TBODY> <TR> <TD width="100%"></TD> <TD align=middle id=rem_INCREDISOUND vAlign=bottom></TD> <TD align=middle id=rem_INCREDIANIM vAlign=bottom></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE><FONT size=2></FONT></DIV><!--/BLOCKQUOTE--> <DIV> </DIV></BLOCKQUOTE></TD></TR> <TR> <TD id=INCREDIFOOTER width="100%"> <TABLE cellPadding=0 cellSpacing=0 width="100%"> <TBODY> <TR> <TD width="100%"></TD> <TD align=middle id=INCREDISOUND vAlign=bottom></TD> <TD align=middle id=INCREDIANIM vAlign=bottom></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE><SPAN id=IncrediStamp><SPAN dir=ltr><FONT face="Arial, Helvetica, sans-serif" size=2>____________________________________________________<BR><FONT face="Comic Sans MS" size=2><A href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://www.incredimail.com/redir.asp?ad_id=309&lang=9"><IMG align=baseline alt="" border=0 hspace=0 src="cid:580143213@30042003-2ea2"></A> <I>IncrediMail</I> - <B>Email has finally evolved</B> - </FONT><A href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://www.incredimail.com/redir.asp?ad_id=309&lang=9"><FONT face="Times New Roman" size=3><B><U>Click Here</U></B></FONT></A></SPAN></SPAN></FONT></BLOCKQUOTE></BODY></HTML> ------_=_NextPart_001_01C30F20.FFE47C00-- ------_=_NextPart_000_01C30F20.FFE47C00 Content-Type: image/gif; name="IMSTP.gif" Content-Transfer-Encoding: base64 Content-Disposition: attachment; filename="IMSTP.gif" Content-ID: <580143213@30042003-2ea2> R0lGODlhFAAPALMIAP9gAM9gAM8vAM9gL/+QL5AvAGAvAP9gL////wAAAAAAAAAAAAAAAAAAAAAA AAAAACH/C05FVFNDQVBFMi4wAwEAAAAh+QQJFAAIACwAAAAAFAAPAAAEVRDJSaudJuudrxlEKI6B URlCUYyjKpgYAKSgOBSCDEuGDKgrAtC3Q/R+hkPJEDgYCjpKr5A8WK9OaPFZwHoPqm3366VKyeRt E30tVVRscMHDqV/u+AgAIfkEBWQACAAsAAAAABQADwAABBIQyUmrvTjrzbv/YCiOZGmeaAQAIfkE CRQACAAsAgABABAADQAABEoQIUOrpXIOwrsPxiQUheeRAgUA49YNhbCqK1kS9grQhXGAhsDBUJgZ AL2Dcqkk7ogFpvRAokSn0p4PO6UIuUsQggSmFjKXdAgRAQAh+QQFCgAIACwAAAAAFAAPAAAEEhDJ Sau9OOvNu/9gKI5kaZ5oBAAh+QQJFAAIACwCAAEAEAANAAAEShAhQ6ulcg7Cuw/GJBSF55ECBQDj 1g2FsKorWRL2CtCFcYCGwMFQmBkAvYNyqSTuiAWm9ECiRKfSng87pQi5SxCCBKYWMpd0CBEBACH5 BAVkAAgALAAAAAAUAA8AAAQSEMlJq7046827/2AojmRpnmgEADs= ------_=_NextPart_000_01C30F20.FFE47C00--
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