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article in the may issue of "Annals of Emergency Medicine"

Krin135 at aol.com Krin135 at aol.com
Sat Apr 22 12:51:28 BST 2006

In a message dated 21-Apr-06 12:57:19 Central Daylight Time,  
JonWalsh at borgess.com writes:

Just the  kind of article I would expect from an EM physician....
Tell them good luck  with the next pt with a ruptured spleen or open book 
pelvic  fx....

and what part of the country do you practice in, Dr.  Walsh?
If you have never practiced in one of the more underserved or  rural areas of 
the US, then you are part of the maldistribution problem, not  part of the 
Patient A is in a major hurt in much of the rural US, and  requires 
appropriate airway stabilization, minimal fluid resuscitation to  maintain a blood 
pressure of approx 90 systolic, and a call for a helo to take  the patient to a 
more appropriate facility.
Patient B is often a bit better off, since along with the above  steps, this 
EM/FM doc also knows that he can tie a bed sheet around their pelvis  and slow 
much of their bleeding while waiting for the helo.
All of which, If I Recall Correctly, was the original thrust of  ATLS as 
first put out by the fine folks in Nebraska, and later by the  Comprehensive Life 
Support Course available from the Minnesota Academy of Family  Physicians.
Charles S. Krin, DO  FAAFP

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