List Archives

Sat Aug 23 02:50:53 BST 2003

This type of response answers the first question in and of
itself 

In terms of the ice "melting" I was actually refering to
gel packs, which by the way are quite readily available. If
you look you will see that major shipping companies ship
vaccines and drugs- including blood- all of which have the
same temperature constraints and only require "re-icing" on
about a 36 hour schedule, I'm sure there would be no
problem if packs are changed every shift. It is also easy
to obtain temperature range indicators or simply leave a
thermometer in place if you really feel it necessary.

Or you can go to an RV dealer and spend ???euro on a mini
fridge and vehicle rewiring. Your choice

By the way I'm not sure that you can say "better service"
although it certainly is cheaper service. 

LTC R Wigle
Republic of Georgia 
--- Martyn Hodson <martyn at greymafia.freeserve.co.uk> wrote:
> 
> ----- Original Message -----
> From: "Richard Wigle MD FACS" <rlwigle at yahoo.com>
> To: "Trauma & Critical Care mailing list"
> <trauma-list at trauma.org>
> Sent: Saturday, August 23, 2003 5:06 AM
> Subject: Re: kepping Tetanus cold on car units
> 
> 
> > I was afraid that might be the answer
> 
> why were you afraid?
> >
> > that now enters into a huge area of what is appropriate
> in
> > a prehospital environment and how best to use limited
> > resources.
> 
> whic his more appropraite  and more importantly which is
> best care for the
> patient ?
> 
> one Paramedic in a car able to treat and release -
> particualrly if the
> alternative would be transportign the pt to the ED and
> back again e.g. the
> frail elderly, those with severe mobility problems ,
> those who are not going
> to follow advice given .....
> 
> or
> 
> a paramedic and a tech in an expensive fontline A+E
> ambulance, a Nurse and a
> Doc at the ED and a PTS crew if we transport this person
> 
> > Indeed it sounds like a return to making house
> > calls albiet with the expense (although not the entire
> > expense) of activating the EMS system. Don't know
> whether
> > its a great idea or not but I guess you will help us
> find
> > out
> 
> these are already EMS activations - the  theory behind it
> as i understnad it
> is to  provide a better service to those calling  -
> exactly why does a
> relatively simple  treatment  which doesn't need hospital
> support support
> services, result in the above scenario of an A+E
> transport to the ED
> involvement of ED staff and PTS transport home?
> >
> > If it was me I would use a small picnic cooler and one
> of
> > those frozen gel packs and peplace them every shift-
> should
> > be more than adequate
> >
> quite probably or as been suggested one of those peltier
> effect  coolboxes -
> the greatest problem with the ice packs is on a long hot
> shift what happens
> if the ice pack melts and the temp of the box strays over
> 8 - the H+S
> fetishists would have you chuck all the stuff in box
> 
> 
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kepping Tetanus cold on car units