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PHTLS, Ground EMS, Air EMS, Chest Tubes

stefmazur at ausdoctors.net stefmazur at ausdoctors.net
Mon Apr 17 11:33:09 BST 2006

This case raises some of the issues that have been discussed earlier.

If the patient "needed" the chest tube for helicopter retrieval then placing it into the liver wouldn't have alleviated that need.  So can we presume that a second chest tube was placed in the appropriate cavity?

If the second chest tube wasn't placed (and the patient suffered no serious consequences of this not occuring) then it would appear the patient didn't need the chest tube in the first place and the first one shouldn't have been attempted at all.  

A little more patient info might add some light (?petrol) to the discussion of this case/scenario.


Stefan Mazur

>At least in Iowa, EMS personnel are part of or represented on the hospital
>trauma committees. Reports are given at each meeting with the trauma director
>present. These reports would include complications of all types. I have been
>involved with this process personally for 10 years. More recently, I have given
>trauma lectures to paramedics, and I have reviewed run/flight sheets personally.
>If there are variances, the individuals are contacted for explanations. Feedback
>and corrective actions are taken. Loop closure is achieved. The PI process
>continues to monitor the situation.
>Kind regards,
>Phil Caropreso, MD, FACS
>Chair, Iowa State COT
>1813 Grand Avenue
>Keokuk, Iowa, USA, 52632
>pjcabdds at mchsi.com
>> In a message dated 4/15/2006 10:51:02 P.M. Central Standard Time,
>> Krin135 at aol.com writes:
>> roydanks at hotmail.com writes:
>> Just 3  days ago at our level  I trauma center, a patient transferred from
>> the
>> scene  had a chest  tube placed in the helicopter...into the liver.
>> Timely,   huh?
>> Was this iatrogenic trauma reviewed by the Trauma program M&M  .   Most
>> helicopter operatoins in the US are OUTSIDE the Trauma  Service review.  Their
>> complications are brieftly presented to the EMS  helicopter director and
>> reported
>> to the ED director, not the surgical trauma  director.    Or at least that is
>> what I have found in some  hospitals that I am aware of and have surveyed
>> k
>> --
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