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Mon Aug 21 06:20:11 BST 2006

Hi all

In South Africa we have front-room medical officers (GP level - non-surgeons who choose to only work in Trauma Unit / ER) and since 2004 emergency medicine trainees (new discipline in SA) who do the ER airway, together with us (the Trauma Surgery attendings and trainee people). Anaesthetists are available only when not busy in the OR (very seldom).

We therefore have to be very skilled at airway options and management. Additionally, with the excessive workload: often three or four cases pending for OR at once and only two EOR at night, any remotely stable cases (e.g. GSW with acute abdo but not active bleeding) will wait their turn in the holding area in the Unit, they do not go to OR holding/recovery area. We will moniotr and prioritise as needed.

Overall the Trauma Service runs the unit, however.

The joys of the mixed first-third world!

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
Program Manager: Emergency Medicine (SU)
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Department of Surgery Room 4064
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of
bensonblues at comcast.net
Sent: Monday, August 21, 2006 5:43 AM
To: trauma-list at trauma.org
Subject: Anesthesia in the ED

At SJH, emergency medicine does the trauma airways (kids and adults) and anesthesia responds only if requested. The residents receive strong training in airway management and anesthesia and become quite good, putting them to sleep and paralyze 'em as necessary. We rarely see anesthesia in the ED, and it has not been a problem in the residency's tens year history. DB
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Anesthesia in the ED