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PHTLS, Ground EMS, Air EMS, Chest Tubes
Roy Danks roydanks at hotmail.comMon Apr 10 03:36:27 BST 2006
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I've followed this thread long enough now to feel as if I can add something. As a trauma surgeon with extensive EMS experience, I must side with Dr. Mattox. EMT's/Paramedics and Flight RNs have no business putting in chest tubes. This is the trauma algorithm: Step 1: Load the patient Step 2: Transport the patient Step 3: Maintain the airway, give some oxygen, etc during transport. Helicopters are fast, flying billboards for hospital systems (by and large). At least one study has refuted the "Golden Hour" concept. Many studies have shot down the concept that air transport "saves lives by saving time" (in trauma). Don't get me wrong: I love EMS and medics. I think they are doing a terrific job under difficult circumstances, but I simply cannot support advanced procedures in the field. And, it's not because I don't think they're capable. It's unneccessary. EMS was developed for the delivery of cardiac care. I am convinced it has a role for this. I'm less convinced of it's role in trauma. Spine and fracture immobilization, oxygen, airway control, etc: YES. Advanced Procedures: NO. RD
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