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Sun May 15 14:52:07 BST 2005

----- Original Message -----
From: "Ben Reynolds" <aneurysm_42 at yahoo.com>
To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Sent: Sunday, May 15, 2005 2:20 PM
Subject: Re: Case

> By the time a sternal rub won't wake him, he's a GONER
> and you've lost EVERYTHING.  Suddenly the
> inconvenience of RSI pales to the morbidity posed by
> the decompressive craniectomy and ventriculostomy he
> may have just bought; a maneuver necessary now that
> his brain has been insidiously subjected to the
> crushing physics of the Monro-Kellie doctrine during
> the hours spent "conservatively managing" his problem.
>  Which ultimately is just waiting for him to sleep it
> off, no?
>
> Oh yeah, let's not forget to mention his bright future
> as a vegetable or an organ donor; a fate which might
> well have been avoided if his injury had been detected
> earlier.
>
> Risk versus benefit, folks.
>
> Ben Reynolds, PA-C
> Pittsburgh, PA

Ben,

We've agreed on plenty in the past, but this little rant of yours is
alarmist nonsense.  If you believe that competent, comprehensive serial
exams would not have picked up a downward trend in this patient until he was
a "GONER" or a "vegetable," then maybe every unpleasant drunk with a bruise
at your hospital SHOULD be intubated and CT'd--for their safety and yours.

Pret

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