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Sat Apr 8 22:01:54 BST 2006

In a message dated 08-Apr-06 15:40:28 Central Daylight Time,  KMATTOX at aol.com 
writes:

In a  message dated 4/8/2006 1:47:33 P.M. Central Standard Time,   
Krin135 at aol.com writes:

Then you  and Rick will be willing to  testify Pro Bono for the  defense if 
an 

outlying trauma case with  a suspicious chest injury does NOT  get a  chest 
tube 
by an  appropriately trained crew and the patient dies  enroute  to the  
receiving trauma facility, having bypassed one or  more small  town  
facilities (with 
ED docs who have a better   armamentarum available than the crew)  which are 
NOT 
trauma   centers?

I would be happy to review such a case, if and when  such a case is produced  
and it falls into the data that you  cite.   Quite honestly, I have not  seen 
or heard of such a  case in military or civilian practice in the past  
several  
decades.   I HAVE seen a significant number of IATROGENIC  (and  even FATAL) 
complications caused by such insertion if needles  and tubes in the  
ambulance, 
helicopter, and non trauma center  personnel.   

Understood, and we have discussed those in the past...including  the (mis) 
use of trocar introducers.

Thank you for being willing to stand behind your position. It  has helped 
some in the past when I was working out in rural areas to be able to  quote 
you...not that the residents at the trauma center wanted to believe that a  small 
town doc might have actually know something because he had learned it 'at  the 
knee' of one of the more prolific authors on Trauma Surgery...Similarly for  
Rick and Errington...

ck

Charles S. Krin, DO  FAAFP

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Clamp the the chest tube in an EMS placed chest tube