List Archives

Sun Apr 9 03:27:55 BST 2006

Rick,

I have forwarded your question to the Chairman of PHTLS.
I will forward his answer as soon as I receive it.

Sue

docrickfry at aol.com wrote:

>I have not seen the last two editions of PHTLS, so perhaps someone can inform me and the rest of us--what does this standard and widely accepted document on prehospital care say exactly about prehospital placement of chest tubes and needles?
>ERF
> 
>-----Original Message-----
>From: Michael Ferker <xg2k2 at yahoo.com>
>To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
>Sent: Sat, 8 Apr 2006 15:55:41 -0700 (PDT)
>Subject: Re: Prehospital Care
>
>
>But who are we trying to prove the benefit to in this scenario? Any colleague 
>who believes this may save a life will likely implement it; those who don't 
>believe it's worth the risk will consider alternatives. In the long run, I 
>believe that it's our duty to first provide the best circumstances possible, in 
>our best educated opinion, that will minimize suffering and optimize the quality 
>of care the pt receives. In cases where there isn't sufficient documentation to 
>lead a provider to inevitably come to a conclusion one way or another regarding 
>whether benefits outweigh the risks, it's up to the provider to determine 
>whether or not such a course of action should be taken; some may opt for it, 
>other may opt against it. But conclusivity at times can be a matter of 
>perspective and quite subjective, so it depends on the individual provides to 
>decide for themselves.
>
>docrickfry at aol.com wrote:  Absolutely there may be--but to follow the tenets of 
>science AND safety first for the patient, it is our obligation to FIRST prove a 
>benefit BEFORE subjecting them to this risk
>ERF 
>
>-----Original Message-----
>From: HAXScott at aol.com
>To: trauma-list at trauma.org
>Sent: Sat, 8 Apr 2006 09:05:31 EDT
>Subject: Re: Prehospital Care
>
>
>...especially when we don't know who or what the modern paramedic is or will 
>be.. Cloud everything the dark side does. 
>
>Is it not unreasonable to concede that there MAY be some benefit to 
>out-of-hospital tube thoracostomy in a select group of patients, in the hands of 
>
>a 
>skilled provider functioning as a member of a critical care transport team, 
>who has intense medical director oversight, answers to a rigorous PI process, 
>in an environment where access to another provider in a hospital setting 
>(physician or mid-level) is not possible within a considerable time frame from 
>injury? 
>
>
>
>
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-- 

Sue Roundy, M.Ed., EMT-P (ret.)
President, High Sierra Resources
email:  suefire6 at charter.net  or  suencbrt at lsu.edu 
National Association of EMT's:  Secretary, Paramedic Division; 
     Liaison to International Association of Emergency Managers 
Past President, Nevada Emergency Medical Assoc.
President & Captain (ret.), Dayton (NV) Volunteer Fire Department 

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"I am the master of my house and what my wife says shall be done."
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