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ATLS

Bjorn, Pret trauma-list@trauma.org
Wed, 30 Apr 2003 10:01:30 -0400


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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

			

 


			
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<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>&nbsp;</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.&nbsp; 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>&nbsp;</DIV>
<DIV><FONT color=#800000 size=2><SPAN class=580143213-30042003>I've quoted 
directly from the current ATLS text below.&nbsp; If I missed something, perhaps 
you'll elaborate.</SPAN></FONT></DIV>
<DIV><FONT color=#800000 size=2><SPAN 
class=580143213-30042003></SPAN></FONT>&nbsp;</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>&nbsp;</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>&nbsp;</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>&nbsp;<SPAN 
class=580143213-30042003>&nbsp;</SPAN></FONT></FONT></DIV>
<BLOCKQUOTE style="MARGIN-RIGHT: 0px">
  <DIV><FONT size=2><FONT color=#800000><SPAN 
  class=580143213-30042003>&nbsp;</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>&nbsp;</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>&nbsp; "<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>."&nbsp;</SPAN></FONT></DIV>
        <DIV><SPAN class=580143213-30042003><FONT color=#800000 
        size=2>&nbsp;</FONT></SPAN></DIV>
        <DIV>THE ISSUE OF DPL VERSUS ULTRASOUND<FONT color=#800000 size=2><SPAN 
        class=580143213-30042003>&nbsp;</SPAN></FONT></DIV>
        <DIV><FONT color=#800000 size=2><SPAN 
        class=580143213-30042003>ATLS:&nbsp; "<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>&nbsp;</SPAN></FONT></DIV>
        <DIV>THE ISSUE OF HYPERVENTILATION IN HEAD TRAUMA<FONT color=#800000 
        size=2><SPAN class=580143213-30042003>&nbsp;</SPAN></FONT></DIV>
        <DIV><FONT color=#800000 size=2><SPAN 
        class=580143213-30042003>ATLS:&nbsp; "<EM>Hyperventilation may 
        be&nbsp;used cautiously in patients who demonstrate [GCS 3-8 and] 
        worsening GCS or pupillary dilitation.&nbsp; The PCO2 should be kept 
        between 25 and 35 mm Hg</EM>."&nbsp;</SPAN></FONT></DIV>
        <DIV>&nbsp;</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>&nbsp;</DIV>
        <DIV>I do indeed plea for a stimulating discussion in this list</DIV>
        <DIV>&nbsp;&nbsp;</DIV>
        <DIV>&nbsp;</DIV>
        <DIV>Dr. Alaa Zidan</DIV>
        <DIV>Orthopaedic surgeon &amp;Team leader</DIV>
        <DIV>Accident&amp;Emergency dept.</DIV>
        <DIV>Salmanyia medical complex.P.O Box 12</DIV>
        <DIV>Manama, Kingdom of Bahrain</DIV>
        <DIV>&nbsp;</DIV>
        <DIV id=IncrediOriginalMessage><I>-------Original 
        Message-------</I></DIV>
        <DIV>&nbsp;</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>&nbsp;</DIV>
        <DIV>99% of ATLS is middle of the road.&nbsp; Good safe medicine.&nbsp; 
        do you have any specific issues?</DIV>
        <DIV>&nbsp;</DIV>
        <DIV>E</DIV>
        <DIV>&nbsp;</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>&nbsp;</DIV>
        <DIV>Don't think you are<BR>Know you 
        are<BR>&nbsp;<BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
        - 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 
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                <DIV>&nbsp;</DIV>
                <DIV id=IncrediOriginalMessage><I>-------Original 
                Message-------</I></DIV>
                <DIV>&nbsp;</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>&nbsp;</DIV>
                <DIV>Dear Trauma list members </DIV>
                <DIV>&nbsp;</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>&nbsp;</DIV>
                <DIV>Best regards</DIV>
                <DIV>&nbsp;</DIV>
                <DIV>DR Alaa zidan</DIV>
                <DIV>SMC, Bahrain</DIV></TD></TR>
            <TR>
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