List Archives

Wed May 18 15:16:00 BST 2005

Since Montana was mentioned, I'll jump in.  I started in this business
as a
volunteer EMT-Basic for a rural service.  I used to take call two days a
week.
 I once went an entire year and responded to two significant traumas.
Skill
maintenance?  Sure, technology can be useful in frontier areas, but most
folks
don't have enough call volume to be proficient.  Better we focus on
airway
management and basic patient assessment.
John Bleicher

John Bleicher, RN
Trauma Coordinator
St. Patrick Hospital and Health Sciences Center
500 West Broadway
Missoula, MT 59802
ph: 406-329-5603
fax: 406-329-5856
bleicher at saintpatrick.org

>>> medic245 at mindspring.com 05/17/05 11:09PM >>>
Wow... I went from'very good thinking' to 'flawed thinking at it's
finest' in
about 30 minutes.

That's gotta be some sort of record.

So, here's the postulated question:

Blunt trauma to abdomen, normal and stable VS, one hour to local
community
hospital/clinic that has no surgery capactiy.  The only ambulance within
2000
square miles gets the choice to transport to this clinic, or to the
regional
trauma center, which is 7 hours away.  

Here, I suppose I can see how a positive FAST would help the decision
making. 

Understand that I don't support this concept in Jacksonville, FLA, where
they
have the benefit of an ambulance every 2 square miles, and trauma
centers
available 24/7.  

But the rest of the world ain't Jacksonville, Dr. Frykberg.  And we all
know
it.  

Best,   

-----Original Message-----
From: DocRickFry at aol.com 
Sent: May 17, 2005 6:07 PM
To: trauma-list at trauma.org 
Subject: Re: prehospital FAST

In a message dated 5/17/2005 8:53:19 P.M. Eastern Daylight Time,  
medic245 at mindspring.com writes:

I  suppose I could see some utility in a place where the patient is  FAR
removed from the hospital, where watching a slowly bleeding injury
develop
could be beneficial, and where resources for transport are so  limited
that
the decision to transport to a trauma center would limit  available
resources
for several hours.

Northern British Columbia,  Alaska, some area of Montana, etc. come to
mind.

There are problems  with this approach, too, but I must be fair... in
such a
setting, a FAST  could be nice to have.

This is flawed thinking at its finest!  Why do you think you need a
FAST to 
"watch bleeding"?  Of what possible benefit to the patient is it to
"watch 
bleeding"?  How would this device at all improve upon--dare I say 
it?--watching 
THE PATIENT?  THE VITAL SIGNS?  And if they worsened,  how is a FAST
going to 
help in isolated areas?
The above is a totally bogus rationalization
ERF
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Best, 

Jeff Brosius
Paramedic, etc.
Phoenix
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