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Sat Apr 8 11:49:47 BST 2006

kokaramc at bellsouth.net wrote:   I totally agree. And to answer the question according to the literature, for every 500ml of blood out of the chest tube, mortality significantly increases. And although there is no magic number, the recommendations are to go to the OR for over 1000ml. We really dont need fire rescue putting in chest tubes.    
  Indeed
  But be advised some of us are approaching this outside the classical "Fire Rescue" scenario

  Otherwise

  Not putting a chest tube = clamping one that you have)))))
  Make up your mind
  Not putting a chest tube is just like clamping one

  Some people are speaking form both side of the face

  Let's stick to the universal Dx/Rx
  Take into account risk/benefits Time/space/ skills & cricumstences
  Let's credentialize specialist acts to the non spcialists

  Let's smarten up the process

  and not just dumb it down

  ... and just for some

  We need this intelligence to our approach

  especially after enduring all these centuries of stupidity
  Whereby doctors were magicaly qualified based
  Too often on professional snobery

  How many cardaic arrest runned by MDs that did not have the ACLS and can only pass the "friendlier" ACLS, how many intubations by doctors who had less practical taining on it than a color medic... and these same people feel obligated to do RSIs 

  And we all agree thes Alphabet courses are good
  But are not quite the level of credentialisation expected in proportion to the risks

  The problem with Medics
  Is that some are doing what the docs have been doing for centuries

  You say stop those rogue Medics
  I stay stop those rogue care giver

  You know

  I think we agree after ALL

  You just don't know it )))))

  Charles

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Clamp the the chest tube in an EMS placed chest tube