List Archives

Sun Oct 15 01:17:10 BST 2006

In a message dated 10/14/2006 7:00:29 P.M. Central Standard Time,  
gabiford at hotmail.com writes:

Take a  chill pill, K.  ;)

Not required. 

1.    The predominant discussion at the AAST and the  ACS was that 
prehospital  and emergency room post traumatic hypotension  care was to allow permissive 
resuscitation and RESTRICT  fluids.     Aggressive fluids resulted in 
repeated  documentation of unacceptable complications.    Should this be  true and 
the predominance of evidence is that it is, then the need for IO and  other 
large bore venous access for large volumes of fluid becomes a mute  point.   

2.    The last I checked, the predominant nursing  organization interacting 
with trauma systems, trauma surgeons, and hospital  policy was the SOCIETY OF 
TRAUMA NURSES, not the ENA.   AND the policy  regarding who is in the OR (or an 
OR surrogate location such as the trauma  resuscitation area of the emergency 
center), is the surgeon, not a national  nursing organization.  The trauma 
surgeons have repeatedly stipulated that  the policy of having family members 
present during surgery is NOT A GOOD  IDEA.   After the surgery is over (either 
in the holding area of the  EC or the PACU) surgeons have no problem with the 
family visiting the patient in  keeping with hospital policy.     

I would recommend that chill out pills are not needed by the surgeons, but  
common sense pills are needed by other clip board carrying policy making do  
gooders who have lost contact with reality.  

k

I just returned from a local trauma course.  One of the topics was, of  
course, intra osseous needles.
The general opinion was that they were  being used more than in the past. 
With the newish screw tips, people claimed  they were easy enough to insert.

Two ER nurses in attendance stated they  had IOs placed and found the pain 
related to the insertion to be minimal --  comparable to having an IV cath 
placed.

Also, was told that the  official position of the ENA (Emergency Nurses 
Association) is in favor of  family's presence during codes.

Take a chill pill, K.   ;)

Gabi, RN

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