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Change of subject; Penetrating trauma to extremity

Avi Roy Shapira avir at bgumail.bgu.ac.il
Thu Apr 20 09:41:15 BST 2006

The apporpirate standard of care is physical examination. If there are no
hard signs of vascular or neurological injury, send them home. 

Some may elect to observe, if there are soft signs.  But this is not
necessary.  Just tell the patients what to look for, and if he comes back
complaining later, work up the complaints. If there are no hard signs, the
extemity will not fall off all of a sudden. 


 On Wed, 19 Apr 2006, Moore,
Rick wrote:

> Good Morning,
> Have an issue in my facility regarding penetrating trauma (specifically
> knife stabwound)to an extremity. What is appropriate standard of care?
> Admission with neurovascular checks, standard CT with contrast or CT
> angiography. And if CT angiography is appropriate under who's direction
> radiolgist or vascular surgeon or trauma surgeon?
> All comments appreciated.
> Rick Moore
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of William Bromberg
> Sent: Wednesday, April 19, 2006 7:33 AM
> To: trauma-list at trauma.org
> Subject: Re: JCAHO REQ: Locked meds in ED
> At our institution (Pyxis) we generate a trauma number prior to arrival
> for every trauma activation. For the highest level activations (unstable
> patients) nurses automatically take RSI drugs from the Pyxis based on
> the pre generated trauma numbers. It sounds to me that the breakdown is
> waiting for the patient to arrive prior to  a number being generated
> which then makes it impossible to pre-order meds.
> Bill Bromberg
> William J. Bromberg
> Savannah Surgical Group
> 912 350-7412
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Aviel Roy-Shapira, M.D.              Soroka University Hospital &
Dept. of Surgery A. and              Ben-Gurion University Medical School 
the Critical Care Unit               POB 151, Beer Sheva, Israel
email:avir at bgumail.bgu.ac.il         Fax:972-7-6403260 voice:972-7-6403390

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