penetrating posterior torax injury continued

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Once again some very poignant points in this thread. It's a "heart-sink"
story and not atypical of some rural areas in various counties.

Yes you need a robust system of fast delivery of patients to a place
capable of doing the job. The system also relies on a small number of
professionals at the workface. The workforce demographics can change so
frequently in rural areas, hence system creation has to allow for that
(easily said from my desk eh?). 

It would seem that you need a "scoop and run" system to your nearest
trauma centre. Hesitation at the front door often doesn't help the
patient. Having said that, I'm not sure it would have helped this one.  

Dare I say, given your description of your local geography, that you
need a helicopter and a good rapid response team.

Kia Ora

Simon Scothern
FRCA, MRCP
ICU Clinical Director/Consultant Anaesthetist
Rotorua Hospital
Pukeroa Hill
Private Bag 3203
 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
Sent: Thursday, 2 November 2006 6:21 a.m.
To: 'Trauma & Critical Care mailing list'
Subject: RE: penetrating posterior torax injury continued

Never the less, going straight to the trauma center was the patient's
only
and best chance at survival. This is one of the most difficult things to
convince people of when implementing a trauma system. The shortest route
to
definitive acute care is best. There is no point in driving the patient
someplace where the injury cannot be meaningfully addressed. There is
also
no point in trying to provide any "treatment" to seriously injured
patients
in the pre-hospital setting.
 
Rob

  _____  

From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of Richard van der Kleyn
Sent: Wednesday, November 01, 2006 12:11 PM
To: trauma-list at trauma.org
Subject: RE: penetrating posterior torax injury continued




prehospital protocols are in place, unfortunatly just for the
medicalised
ambulance (of which we hace one covering a poulacion of about 100,000
(in
the summer anywhere up to 400,000) and an area including mountains. In
this
casa this ambulance was occupied and the medical ambulance was sent out
from
the trauma center (35-40 minutes), the normal paramedics arn't used to
taking theses decisions and the only treatment the can give is O2. If
they
had gone straight to the trauma center in this casa the pacient would
have
arested in the ambulance in the time to get to the trauma center.

 

i agree that a lot of work has to be done (and money) in the prehospital
setting to reach the standards of most european countries


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