[ccm-l] Massive fluid infusions

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All, 
 
This is a fundamental problem with Trauma care, and essentially all credentialing/verifying bodies (ACS COT, RRC, JCAHO). Best geuss becomes dogma without any confirmatory evidence. In my humble opinion, all absolute requirements should be based ONLY on Class 1 evidence. 
 
Steve Smith 
 
-----Original Message-----
From: Charles Brault <c_brault at yahoo.com>
To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
Sent: Sat, 2 Jul 2005 12:18:26 -0700 (PDT)
Subject: Re: [ccm-l] Massive fluid infusions


One of our Level 1 Trauma center
Used it on an 18 yo motorcycle accident with a relatively
isolated Femur fracture.
The kid got 16 liters in 2 hours

It killed him !

I can not begin to imagine the circonstancial evidences

Charles

--- KMATTOX at aol.com wrote:

> Steve:
>  
> We almost flunked one of our trauma center verification
> visits in the past  
> because we did not have one of these devices physically
> in the shock room of 
> the  emergency room.   We did have them in the OR and in
> the ICU and did on  
> very rare occassion use them there.   We did have a
> protocol to bring  one to the 
> EC if so needed, but the patients were in the OR too 
> quick.   However, 
> because the site visitors were insistant, we did go  out
> and buy one.   It has been 
> in the EC every since, gathering dust,  never used, and
> is a convienient coat 
> rack.   We have a lot of  interesting photographs taken
> with coats drapped 
> over it.   We have  not regreted during our M&M that we
> did not use these 
> gadgets in the  EC.     But it is there.  Because we
> spent money and  put it there 
> so that we were in compliance, our "warning" was 
> removed.     
>  
> Yes, I most definitely believe that the requirement for
> this gadget and a  
> number of unfounded principles need to be reviewed by
> both the VRC, ATLS, and  
> other committees of the ACS COT.   It is a matter of 
> crediability.  
>  
> k
> --
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