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Wed Jun 15 06:04:57 BST 2005

Ron

Yes really: we are in the situation someone described earlier of the overloaded system where its safer to be proactive than reactive, since the aftercare in the post anaesthesia unit is dependant entirely on nurses who can't do chest drains - while the surgeons and anaesthetists are busy with the next case.

Tim

-----Original Message-----
From: Ronald Gross [mailto:Rgross at harthosp.org]
Sent: Tuesday, June 14, 2005 3:19 PM
To: trauma-list at trauma.org
Subject: RE: Chest drain or not?

Tim,

REALLY?????

Best wishes,
Ron

>>> tch at sun.ac.za 6/14/2005 9:07:14 AM >>>
Me

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
General Surgeon (Trauma and ICU)
ATLS and DSTC instructor
Intern program Coordinator: Surgery
Program Manager: Emergency Medicine (U.S.)
Operational Head: Diana Princess of Wales Trauma Unit
Department of Surgery Room 4064
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa

2 Lorient Close
Vredekloof, Brackenfell
7560, Western Cape,
South Africa
e-mail: tch at sun.ac.za 
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302
Home: +27219813098

-----Original Message-----
From: Caesar Ursic [mailto:cursic at gmail.com] 
Sent: Tuesday, June 14, 2005 1:16 AM
To: Trauma & Critical Care mailing list
Subject: Re: Chest drain or not?

Let's make this more interesting:  who would insert a chest tube in
this patient if he was needing to go to the operating room for, let's
say, an open reduction of an ankle fracture, under a general
anesthetic (i.e. positive pressure ventilation)?

CM Ursic

On 6/14/05, Marcin & Ania <zawisza at lineone.net> wrote:
> A forty five year old man came in following an injury during a football
> (soccer for the over seas docs)match. He got elbowed into the right side of
> his chest. Localised trauma only no other injuries.
> O/E RR 25, shallow breaths, sats 94-95% on air, bilateral air entry but
> obviously palpable surgical emphysema over the area of injury, BP 140/85,
> Pulse 105. The guy is otherwise fit and healthy. Sorry I do not have a chest
> X-ray so you'll have to take my word for it that there was NO sign of
> pneumothorax but he did have 2 obviously fractured ribs (5th and 6th) which
> were significantly displaced.
> So who'd put chest drain in and who wouldn't?
> 
> Martin
> 
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Chest drain or not?