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Article in Annals EM

Zsolt Balogh zsoltbalogh at yahoo.com
Sun Apr 23 14:41:38 BST 2006

Dear DB,
  Unfortunately those who are not responsible for they decisions to operate (ED, Navy corps etc..) can not mak ethe decisions so the surgeon's place is unfortunately in ED or in ambulance bay at first not in the OR scrubbed. Especially in those areas of the world where trauma patients are less and less likely to go staright to OR.
Zsolt Balogh
bensonblues at comcast.net wrote:
  The article merely points out what we already know. A surgeon does not have to be present upon the patient's arrival to the ED to receive quality care. If a patient arrives to the ED needing an operation, I believe the best place for the surgeon to be is in the OR scrubbing up. A well-trained EM doc (or Navy corpsman, for that matter) can handle the initial management of the trauma victim as good as anyone else (maybe even better, because of airway skills, etc.). Much of the initial trauma care in the US is provided by an EM physician who wakes the surgeon up at 2 am and waits 30 minutes for their arrival (or transfers the pt). It would be nice if we had surgeons in every ED throughout the country, but there's not enough of them and they wouldn't be able to make a living. Those of us who work at big centers with 24 hr surgery residents and attendings forget this point - and we are spoiled (and like it that way). This should be kept in mind where surgeons are involved in
ing EM
residents - train them well, and they won't be waking your surgical graduates up unnecessarilly in the middle of the night at the smaller hospitals most tend to work at; and if your are needed, you will have a patient to bill for services when you arrive. Everybody has their job to do, and team work is is the patient's best interest. DB
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