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Mon Apr 10 01:21:50 BST 2006

Having just spent the weekend teaching PHTLS, Ashton is correct, 
obviously since he quoted the book. What it means to load and go is one 
of the "discussions" we in every PHTLS class I have ever taught over 
these many years.

PHTLS, does not teach you to load and go and NOT do any other 
treatment. It DOES teach you to get on the road asap and treat enroute. 
I have always questioned if this continued "interpretation" of load and 
go is somehow connected to one's lack of confidence in skills being 
performed in the back of moving ambulances...i.e..IVs, airway 
management, etc?

Regardless, the point is, treat enroute to definitive care (Trauma 
Center I or II in Iowa). And as per the topic of this thread as it 
began, never have know a medic to place a chest tube, in my state, and 
certainly have not ever seen it taught in PHTLS, oh these many, many 
years.

   Jules

Julie K. Scadden, NREMT-P, PS
Iowa

Be your own work of art.
Cultivate friends, passions, a distinctive style.
Learn, dare, and grow.

-----Original Message-----
From: Ashton Treadway <napthene at gmail.com>
To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
Sent: Sun, 9 Apr 2006 16:47:21 -0700
Subject: Re: Clamp the the chest tube?

  Howdy:

At least in /my/ neck of the woods, we're being trained and taught to
view the nearest trauma center as definitive care for trauma: any
intervention (IV, etc) beyond gaining control of the airway waits
until we're rolling (or flying), with the obvious caveats for delayed
extrications and the like.

>From my Revised Fifth Edition of PHTLS (ISBN-13 978-0-323-02744-1), 
page 75:

"If life-threatening conditions are identified during the primary
survey, the patient should be rapidly packaged after initiating
limited field intervention. Transport of critically injury [sic]
patients to the closest appropriate facility should be initiated as
soon as possible (Box 3-2). Unless extenuating circumstances exist,
the provider should limit the scene time to 10 minutes or less for
these patients. The provider must realize that limiting scene time and
initiation of rapid transport to the closest appropriate facility,
preferably a trauma center, are fundamental aspects of prehospital
trauma resuscitation."

My $.02 from Northern California.

Ashton

On 4/9/06, J.A. Terranson <measl at mfn.org> wrote:
>
> On Sat, 8 Apr 2006 docrickfry at aol.com wrote:
>
> > Please refresh--when did we ever leave it?
>
> While i can't speak to your neck of the woods, in New York we left 
this
> behind in the late '80s.  In fact, until the NYFD borged our EMS, our
> EMT-Ps (and often our "EMTPYs" [awful emts] were pretty close to 
actually
> practicing independent medicine.  Where are *you* that scoop and run 
is
> still the norm?
>
>
> > ERF
> >
> > -----Original Message-----
> > From: J.A. Terranson <measl at mfn.org>
> > To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
> > Sent: Sat, 8 Apr 2006 12:56:50 -0500 (CDT)
> > Subject: Re: Clamp the the chest tube?
> >
> >
> >
> > So, are you proposing we go back to "Scoop and Run"?
> >
> >

[trimmed]
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Clamp the the chest tube?