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Thu Oct 12 14:29:31 BST 2006

Agree with Dr. Gross..............the trauma patient is ours (unless isolated 
ortho with a minor mechanism), regardless of whether we operate or not -- 
even if the trauma mechanism plays a minor role (i.e. ground-level fall in a 
patient with ICH on ASA/plavix/coumadin and requires emergent reversal, GLF in an 
elderly patient with rib fractures who might benefit from an epidural or 
morphine nebs, etc.)..............these patients need an intensivist, and in the 
U.S. (at least at the majority of Level I and II centers), it is the trauma 
intensivist/surgeon

Dell.........................

Forrest O. Moore, MD
Division of Trauma & Surgical Critical Care
East Texas Medical Center
1020 E. Idel
Tyler, TX 75701
Cell (903) 279-2123

In a message dated 10/12/2006 8:32:09 AM Eastern Standard Time, 
Rgross at harthosp.org writes:
Hi Tony,
lets make one thing clear here - Mattox is NEVER provocative..... 
YEAH, RIGHT!  ;-)
All kidding aside, I think that we are relatively spoiled here at
Hartford.  We still follow the "15 minute rule" - in fact we are in
house and frequently beat the patient in the doors because of our pager
alert system.  We also stay with the patient from arrival to ICU to
discharge, whether the patient gets an operation or not.  And unless the
patient really does have an isolated ortho or neurologic injury that
requires surgery, the patients usually stay on our service for the
duration.  So my comments are, clearly, coming from my point of bias.
On the other hand, if I did not believe that this is the way it should
be, I clearly would not have come here and stayed here........Now it is
my turn to be provocative as I afffirm my very strong conviction that
trauma is a surgical disease, and should be managed by surgeons.
Best wishes,
Ron

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Subacute Care Surgery (was trauma activation and stratification)