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Mandatory ATLS / other courses
Ronald Gross Rgross at harthosp.orgMon Oct 16 15:02:28 BST 2006
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"They are as likely to meet an accident on the road as the "average" physician, and I would think all participants should follow exactly the same education and assessment during the course." "They are as likely to meet an accident on the road as the "average" physician, and I would think all participants should follow exactly the same education and assessment during the course." That is what PHTLS is for. ATLS is for the folks who need to know how to care for the patient once he/she hits the doors of the ED. >>> "Alasdair Waite" <alasdairwaite at doctors.org.uk> 10/14/2006 2:07 PM >>> ATLS is probably one of the few examples of an international system that has fairly universal acceptance as a good thing. If you work in trauma related work in the UK, then a significant number of you colleagues will have gone through ATLS training. It is therefore worth doing so you all have a similar framework in your initial approach to the trauma patient. If you move country, then there's a good chance that your new colleagues will approach the patient in a similar way if they have also done ATLS. However, with limited study leave budgets and restricted time to maintain external education, devoting a large percentage of it to only ATLS may leave you deficient in other areas. If making it mandatory ensures funding is allocated and ring fenced for trauma training, then it could be a very good idea. However, unless you have unlimited (or ring fenced additional) resources, you would have to ensure that the ATLS was the best and value for money. You would need to prove it was better than other courses e.g ATACC (I have not done ATACC so cannot comment on it apart from holding it up as an example of a well regarded alternative). If you are regularly dealing with trauma patients, you should be keeping current along with your colleagues. It may be more educationally valid to attend a different trauma course or conference to learn what others are doing and compare it with what you are doing. While ATLS is updated and should do this, we all know practise in medicine can sometimes change quickly. Does ATLS, as such a large "institution" have the ability to evolve quickly enough? I think ATLS is good. I think everyone involved in trauma care should have done it once (more if they want to). I'm not so sure it should be your only form of trauma education though. There's no way doing one course can substitute for a lifetimes experience. Regard it as a building block in your trauma education. One thing I'm slightly uncomfortable with is why the non-physician participants are treated differently. They are as likely to meet an accident on the road as the "average" physician, and I would think all participants should follow exactly the same education and assessment during the course. It will not change the practise restrictions imposed by the participants registration, but could significantly improve understanding between professionals during an incident. I've sbesequently learnt a lot about pre-hospital care from paramedic colleagues, and I felt the segregation was a deficiency when I did the course. I'd be grateful if someone could explain the rationale behind the segregation (regardless of whether or not it has evidence base) A.Waite, MBChB, FRCA Consultant Anaesthetist (Anaesthesiologist), UK -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of trauma-list-request at trauma.org Sent: 14 October 2006 12:00 To: trauma-list at trauma.org Subject: trauma-list Digest, Vol 40, Issue 25 Send trauma-list mailing list submissions to trauma-list at trauma.org To subscribe or unsubscribe via the World Wide Web, visit http://list.mistral.net/mailman/listinfo/trauma-list or, via email, send a message with subject or body 'help' to trauma-list-request at trauma.org You can reach the person managing the list at trauma-list-owner at trauma.org When replying, please edit your Subject line so it is more specific than "Re: Contents of trauma-list digest..." Today's Topics: 1. RE: ATLS training (Anthony Caruso) 2. Suture Kits (Charlene M Morris) 3. RE: ATLS training (Moore, Rick) 4. Re: ATLS training (Krin135 at aol.com) 5. Re: ATLS training (Krin135 at aol.com) 6. Re: The ATLS evidence argument (Mike) 7. Nice. (Charlene M Morris) ---------------------------------------------------------------------- Message: 1 Date: Fri, 13 Oct 2006 10:13:47 -0400 From: "Anthony Caruso" <Medic541 at hotmail.com> Subject: RE: ATLS training To: "'Trauma & Critical Care mailing list'" <trauma-list at trauma.org> Message-ID: <BAY103-DAV13868FC36E096A879F1218990A0 at phx.gbl> Content-Type: text/plain; charset="US-ASCII" Rick, I just wanted to tell you that I did participate in the skills stations at the ATLS in Boston's Beth Israel hospital. I participated in skill stations to the best of my training would allow me. I truly have to say, out of the classes that I have taken post paramedic school, this has had the most impact on my knowledge base! Dr. Gross, I have had similar situations as to where a medical professional's have been on scene with me and it could go two ways; #1, barking orders out are not well received by anyone. That's just human nature. I can say with experience, that is a sure way to get someone removed from the scene and keep them in the stands as an observer. #2, If someone is maintaining an airway or performing CPR, or in some way is helping out with ABC's or C-spine immobilization and they appear to be competent at what there doing then I let them continue as I set up my equipment. I ask in the process of setting up my equipment what medical professional they are in durrung process just, to attain with whom is helping me out. I personally, would always welcome a medical consult (and possibly assistance) from a physician with particular knowledge of the situation on hand. They would of course, have to assume care of that patient and would be in constant contact with our medical control physician and come for a ride to the hospital in the rig. (State wide medical protocols dictate that) My wife tells me "better to keep your mouth shut than to open it, than look like a fool" I cant imagine why she would say that to me. Maybe she's onto something! Take care all, Anthony M. Caruso NREMT-P -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Moore, Rick Sent: Thursday, October 12, 2006 10:37 AM To: Trauma & Critical Care mailing list Subject: RE: ATLS training Dr. Gross, Possibly I am missing something here, but I have looked into ATLS on many occasions from various providers and I have been told that I may audit the course (as an RN or Paramedic) but that I will not be able to participate in the skills stations or competency testing. If this is not correct possibly the ATLS training programs need to refer to the ATLS manual. REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Ronald Gross Sent: Thursday, October 12, 2006 9:15 AM To: Trauma & Critical Care mailing list Subject: RE: ATLS training Rick, You are wrong - please refer to the ATLS manual. RIG >>> "Moore, Rick" <Rick.Moore at TriadHospitals.com> 10/11/2006 9:54 AM >>> Oh please!! A one weekend course is better than a multi year residency? Give me a break! And by the way in that rural environment that your talking about, the first responders won't be trained in ATLS, because a) they can't afford it and b) they aren't allowed to train in and perform the skills portions if they do come up with the money. REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Juan Duchesne Sent: Tuesday, October 10, 2006 4:53 PM To: trauma-list at trauma.org Subject: RE: ATLS training ATLS save lives.......end of discussion guys!......this is not about a certificate, audit, CME or waste of time.....this is about personal commitment in doing what is best for patient care.......We need to stop this attitude about what ATLS really means.........I will like to read any LEVEL I EVIDENCE THAT ANY residency ED,SURGERY..... IS EQUAL OR BETTER THAN ATLS TRAINING........if any question place YOURSELF OR YOUR FAMILY in a rural environment where your first responder is not ATLS trained.......I HAVE BEEN THERE!!!.....AND IS NOT FUN OR FAIR!........END OF DISCUSSION! Let's move on. juan Juan C Duchesne, M.D. University of Mississippi Medical Center Assistant Professor of Surgery/Trauma and Critical Care Louisiana ATLS State Faculty 2500 North State Street Jackson MS 39216 >>> Rick.Moore at TriadHospitals.com 10/10/06 12:55 PM >>> Since when is an off-duty physician who happens to be driving by or otherwise in the neighborhood "duty bound" to respond and assist? REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Patrick Greiffenstein Sent: Tuesday, October 10, 2006 12:42 PM To: trauma-list at trauma.org Subject: Re: ATLS training I agree with Dr Duchesne. ATLS is a basic skills course that is not very demanding to take and would benefit ANYONE being involved with any patient. Given the fact that we might come accross a trauma scene outside of the hospital (I've counted three since I graduated med school four years ago!) and the fact that we as physicians are duty-bound to respond, it is a course that every physician should take in an ideal world. One would think that practicing MDs would be well acquainted with most of the basics covered by ATLS. As an ATLS instructor I can tell you that it is absolutely frightening how many general surgeons and ED-program graduates, not to mention orthopods, FP's, internists and others who have opted to take our course that have clearly no clue what the basics are (this is AFTER several hours of lecture on the subject). I believe that too much rides on a smoothly-working trauma team and that redundancy, when feasible, can avert disaster. If everyone knows what everyone else is supposed to be doing, things might be missed or overlooked less often. Given the stakes and the time-constraints, I think a little weekend course twice every decade is a miniscule price to pay. my 1.5 cent's worth -Patrick Greiffenstein Resident, General Surgery LSUHSC, New Orleans pgreif at lsuhsc.edu On 10/6/06, trauma-list-request at trauma.org <trauma-list-request at trauma.org > wrote: > > Send trauma-list mailing list submissions to > trauma-list at trauma.org > > To subscribe or unsubscribe via the World Wide Web, visit > http://list.mistral.net/mailman/listinfo/trauma-list > or, via email, send a message with subject or body 'help' to > trauma-list-request at trauma.org > > You can reach the person managing the list at > trauma-list-owner at trauma.org > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of trauma-list digest..." > > > Today's Topics: > > 1. Re: ATLS for consultants... (Juan Duchesne) > 2. Re: ATLS for consultants... (Ronald Simon) > 3. Re: ATLS for consultants... (Jago Miloguz) > 4. RE: ATLS for consultants... (Hotz, Heidi, RN) > 5. Re: ATLS for consultants... (Ronald Gross) > 6. Re: ATLS for consultants... (Ronald Gross) > 7. NoM Spleen Returns (Bjorn, Pret) > > > > ---------- Forwarded message ---------- > From: "Juan Duchesne" <JDuchesne at surgery.umsmed.edu><~!B*+R^&>> To: <rfsmithmd at comcast.net>, <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 08:59:51 -0500 > Subject: Re: ATLS for consultants... > I strongly disagree with your statement Dr. Smith. I work in that > same enviroment you are describing were our ED staff refuse to do > ATLS, their explanation is that ED training (3-4 years) and recert (q > 10 years) equalls ATLS (2 days q 4 years)......we are just asking 2 DAYS for cert. > and one day for recert.!!!! how bad can that be for GOD > sake!!!.............. This is not about MD ego's Dr Smith........this > is very simple and clinically demostrated: ATLS DEFINITIVELY IMPACT > PATIENT CARE!!....let all jump on the boat and work as a > team!........As for consultants even if they are not first responders > to activation we still mandate they get their ATLS. > juan > > Juan C Duchesne, M.D. > University of Mississippi Medical Center Assistant Professor of > Surgery/Trauma and Critical Care 2500 North State Street Jackson MS > 39216 > >>> rfsmithmd at comcast.net 10/06/06 2:32 AM >>> > I am a huge fan of ATLS but I am curious as to the rational for > requiring consultants OR primary trauma providers to have taken ATLS. > How will this positively impact the care of the injured patient? > Hopefully the consultants will not be directing the resuscitation or > initial evaluation of the patient. Conversely ATLS will not have a > meaningful impact on the experience of trauma providers compared to a > full residency in either surgery or emergency medicine. > > R. Smith MD > > -------------- Original message -------------- > From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>><~!B*+R^&>> > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, > > etc) should be required to have taken ATLS to care for a trauma pt. > > The question is whether this should be part of the requirements for > > trauma > > > center designation. No question that members of the trauma service > > and > > > the ED should but what about the subspecialists? Sure its a good > concept > > but actually getting them to take it is another thing. What is the > > practice of other trauma systems? > > Thanks > > Ron Simon, MD > > Jacobi Medical Center > > Bronx, NY > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > ---------- Forwarded message ---------- > From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>> To: "Trauma & Critical Care mailing list" < > trauma-list at trauma.org> > Date: Fri, 06 Oct 2006 11:15:20 -0400 > Subject: Re: ATLS for consultants... > The thoughts behind requiring consultants to take the course is for > them to understand how we prioritize and why we may ask them to go > away and come back later. ron simon > > rfsmithmd at comcast.net wrote: > > >I am a huge fan of ATLS but I am curious as to the rational for > >requiring > consultants OR primary trauma providers to have taken ATLS. How will > this positively impact the care of the injured patient? Hopefully the > consultants will not be directing the resuscitation or initial > evaluation of the patient. Conversely ATLS will not have a meaningful > impact on the experience of trauma providers compared to a full > residency in either surgery or emergency medicine. > > > >R. Smith MD > > > >-------------- Original message -------------- > >From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>> > > > > > > >>We are currently having a debate in our State Trauma Advisory > >>Committee about whether trauma related consultants (neurosurg, > >>ortho, ent, etc) should be required to have taken ATLS to care for a > >>trauma pt. The question is whether this should be part of the > >>requirements for trauma center designation. No question that members > >>of the trauma service and the ED should but what about the > >>subspecialists? Sure its a good concept but actually getting them to > >>take it is another thing. What is the practice of other trauma systems? > >>Thanks > >>Ron Simon, MD > >>Jacobi Medical Center > >>Bronx, NY > >> > >>-- > >>trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > >>settings or unsubscribe visit: http://www.trauma.org/traumalist.html > >> > >> > >-- > >trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > >or unsubscribe visit: > >http://www.trauma.org/traumalist.html > > > > > > > > -- > Ronald Simon, MD > Dir of Trauma/SICU > Jacobi Medical Center, Rm 1213 > Bronx, NY 10461 > 718 918 5598 phone > 718 918 5593 fax > > > > > > ---------- Forwarded message ---------- > From: "Jago Miloguz" < japrak at gmail.com> > To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 6 Oct 2006 17:58:49 +0200 > Subject: Re: ATLS for consultants... > well it would be ideal to have everybody who gets in touch with trauma > patient pass the ATLS but obviously it is quite irrational to wish, > but l think it should be officialy mandatory for all personal dealing > with to intiative managment of trauma patients to pass ATLS(EM docs > and acute care and trauma surgeons).if every hospital has those docs > with passed ATLS then patients would probably do just fine with > consultants not passing ATLS. just my opinion > ante > > > 2006/10/6, Ronald Simon <Traumamd at nyc.rr.com>:<~!B*+R^&>> > > > The thoughts behind requiring consultants to take the course is for > > them > > > to understand how we prioritize and why we may ask them to go away > > and come back later. > > ron simon > > > > rfsmithmd at comcast.net wrote: > > > > >I am a huge fan of ATLS but I am curious as to the rational for > requiring > > consultants OR primary trauma providers to have taken ATLS. How will > this > > positively impact the care of the injured patient? Hopefully the > consultants > > will not be directing the resuscitation or initial evaluation of the > > patient. Conversely ATLS will not have a meaningful impact on the > experience > > of trauma providers compared to a full residency in either surgery > > or emergency medicine. > > > > > >R. Smith MD > > > > > >-------------- Original message -------------- > > >From: Ronald Simon <Traumamd at nyc.rr.com > > > > > > > > > > > > >>We are currently having a debate in our State Trauma Advisory > Committee > > >>about whether trauma related consultants (neurosurg, ortho, ent, > > >>etc) should be required to have taken ATLS to care for a trauma > > >>pt. The question is whether this should be part of the > > >>requirements for trauma center designation. No question that > > >>members of the trauma service and > > > >>the ED should but what about the subspecialists? Sure its a good > concept > > >>but actually getting them to take it is another thing. What is the > > >>practice of other trauma systems? > > >>Thanks > > >>Ron Simon, MD > > >>Jacobi Medical Center > > >>Bronx, NY > > >> > > >>-- > > >>trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > >>settings or unsubscribe visit: > > >>http://www.trauma.org/traumalist.html > > >> > > >> > > >-- > > >trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > >settings or unsubscribe visit: > > >http://www.trauma.org/traumalist.html > > > > > > > > > > > > > -- > > Ronald Simon, MD > > Dir of Trauma/SICU > > Jacobi Medical Center, Rm 1213 > > Bronx, NY 10461 > > 718 918 5598 phone > > 718 918 5593 fax > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > > > > > > > ---------- Forwarded message ---------- > From: "Hotz, Heidi, RN" <Heidi.Hotz at cshs.org><~!B*+R^&>> To: 'Trauma &' < trauma-list at trauma.org> > Date: Fri, 6 Oct 2006 09:11:36 -0700 > Subject: RE: ATLS for consultants... > Ron, > > All of our EM physicians have completed ATLS once in their lifetime > (thus, we adhere to the ACS Gold Book criteria.) With regards to our > consultants from Ortho and Neurosurgery, it is not a formal > requirement, but we have some of them become ATLS Instructors because > they want to; believe it is their duty working at a Level I trauma > hospital; etc, etc. We have two orthopedic trauma surgeons that are > Instructors. We run two ATLS courses per year, so they only need to > teach once yearly. > > Our County trauma contract and State Regs do not require them to have > ATLS. > > Hope this helps. > > Best of luck. > > Heidi > > Heidi A. Hotz, RN, Trauma Program Manager Department of Surgery > Cedars-Sinai Medical Center 8700 Beverly Blvd. Los Angeles, CA 90048 > > Office: 310-423-8732 > Cell: 310-430-2649 > Pager: 310-960-6341 > Fax: 310-423-0139 > > -----Original Message----- > From: trauma-list-bounces at trauma.org > [mailto:trauma-list-bounces at trauma.org > ] > On Behalf Of Ronald Simon > Sent: Thursday, October 05, 2006 6:16 PM > To: trauma-list at trauma.org > Subject: ATLS for consultants... > > We are currently having a debate in our State Trauma Advisory > Committee about whether trauma related consultants (neurosurg, ortho, > ent, etc) should be required to have taken ATLS to care for a trauma > pt. The question is whether this should be part of the requirements > for trauma center designation. No question that members of the trauma > service and the ED should but what about the subspecialists? Sure its > a good concept but actually getting them to take it is another thing. > What is the practice of other trauma systems? > Thanks > Ron Simon, MD > Jacobi Medical Center > Bronx, NY > > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > ---------- Forwarded message ---------- > From: "Ronald Gross" < Rgross at harthosp.org> > To: <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 12:20:12 -0400 > Subject: Re: ATLS for consultants... > Ron, > > We require that ortho and neurosurgeons take ATLS at least once. > > Please note that the ACS COT "Optimal Resourses" document states that, > "At a minimum, orthopaedic surgeons on the trauma team should be > encouraged to successfully complete an ATLS Student Course." The same > statement is repeated in the neurosurgical chapter: "At a minimum, > neurosurgeons on the trauma team should be encouraged to successfully > complete an ATLS Student Course." > > Best wishes, > Ron > > >>> Ronald Simon <Traumamd at nyc.rr.com> 10/5/2006 9:16 PM >>> > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, etc) > should be required to have taken ATLS to care for a trauma pt. The > question is whether this should be part of the requirements for trauma > > center designation. No question that members of the trauma service and > > the ED should but what about the subspecialists? Sure its a good > concept but actually getting them to take it is another thing. What is > the practice of other trauma systems? > Thanks > Ron Simon, MD > Jacobi Medical Center > Bronx, NY > > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > > > > ---------- Forwarded message ---------- > From: "Ronald Gross" < Rgross at harthosp.org> > To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 12:25:41 -0400 > Subject: Re: ATLS for consultants... > The concept is to ensure that the subspecialists see, learn about and > understand the overall picture of trauma care, how the concept of a > systems/team approach to trauma care actually includes them, and that > they should incorporate it into their lexicon....... > > >>> <rfsmithmd at comcast.net> 10/6/2006 3:32 AM >>> > I am a huge fan of ATLS but I am curious as to the rational for > requiring consultants OR primary trauma providers to have taken ATLS. > How will this positively impact the care of the injured patient? > Hopefully the consultants will not be directing the resuscitation or > initial evaluation of the patient. Conversely ATLS will not have a > meaningful impact on the experience of trauma providers compared to a > full residency in either surgery or emergency medicine. > > R. Smith MD > > -------------- Original message -------------- > From: Ronald Simon < Traumamd at nyc.rr.com> > > > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, > > etc) > > > should be required to have taken ATLS to care for a trauma pt. The > > question is whether this should be part of the requirements for > trauma > > center designation. No question that members of the trauma service > and > > the ED should but what about the subspecialists? Sure its a good > concept > > but actually getting them to take it is another thing. What is the > > practice of other trauma systems? > > Thanks > > Ron Simon, MD > > Jacobi Medical Center > > Bronx, NY > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > > > > ---------- Forwarded message ---------- > From: "Bjorn, Pret" <pbjorn at emh.org><~!B*+R^&>> To: < trauma-list at trauma.org> > Date: Fri, 6 Oct 2006 12:18:52 -0400 > Subject: NoM Spleen Returns > Adult female MVC. Left rib fx's 10-12, known splenic inj, read as > Grade I in spite of contrast blush (not intended as the thrust of this > thread). > > The patient was admitted for two nights, stable throughout, and > discharged with her cooperation and enthusiasm. She was prescribed > house arrest for a week, drastically limited activity, and an office > visit to follow. > > As fate would have it, on post-injury day 6 she suffered a sudden > sharp LUQ pain with what sounds like a brief vagal response. She > reported immediately to her local ED, where another CT shows both a > persistent blush plus intraperitoneal hemorrhage (second image). > > At the local hospital, vitals were stable (she was in fact > hypertensive consistent with her medical history) and her labs were > unremarkable (H&H 12 and 35, roughly identical to previous discharge > numbers). She was > admitted to the local hospital for observation, but her counts slipped > overnight (10 & 27), and so she was transferred back to us. She > arrives stable and without any major complaints. Even a little hungry. > > Interested in what others would plan for her. Observe? Coil? Both? > Other? > > Pret Bjorn, RN > > > <<FirstImage.jpg>> <<SecondImage.jpg>><~!B*+R^&>><~!B*+R^&>><~!B*+R^&>> -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html ------------------------------ Message: 2 Date: Fri, 13 Oct 2006 09:20:55 -0500 From: "Charlene M Morris" <cvmmorris at gmail.com> Subject: Suture Kits To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org> Message-ID: <ca095570610130720w780fae9drd2564e498012204f at mail.gmail.com> Content-Type: text/plain; charset=ISO-8859-1; format=flowed As the CME person for APFFA, I am in desperate need of ~60 suture kits at reasonable price. If anyone can guide me, I would appreciate it. Charlene Morris www.afppa.org ------------------------------ Message: 3 Date: Fri, 13 Oct 2006 09:24:59 -0500 From: "Moore, Rick" <Rick.Moore at TriadHospitals.com> Subject: RE: ATLS training To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org> Message-ID: <8B63039C9DF4554C8FDBF31235F0E1480222B641 at CPRTEVS02.triadhospitals.net> Content-Type: text/plain; charset="US-ASCII" Cool, Thanks for that info. I am also looking at the CALS course that someone mentioned on here during the discussion as well. And I agree, if a medical professional on scene is actually helping, they are more than welcome to stick around. Rick -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Anthony Caruso Sent: Friday, October 13, 2006 9:14 AM To: 'Trauma & Critical Care mailing list' Subject: RE: ATLS training Rick, I just wanted to tell you that I did participate in the skills stations at the ATLS in Boston's Beth Israel hospital. I participated in skill stations to the best of my training would allow me. I truly have to say, out of the classes that I have taken post paramedic school, this has had the most impact on my knowledge base! Dr. Gross, I have had similar situations as to where a medical professional's have been on scene with me and it could go two ways; #1, barking orders out are not well received by anyone. That's just human nature. I can say with experience, that is a sure way to get someone removed from the scene and keep them in the stands as an observer. #2, If someone is maintaining an airway or performing CPR, or in some way is helping out with ABC's or C-spine immobilization and they appear to be competent at what there doing then I let them continue as I set up my equipment. I ask in the process of setting up my equipment what medical professional they are in durrung process just, to attain with whom is helping me out. I personally, would always welcome a medical consult (and possibly assistance) from a physician with particular knowledge of the situation on hand. They would of course, have to assume care of that patient and would be in constant contact with our medical control physician and come for a ride to the hospital in the rig. (State wide medical protocols dictate that) My wife tells me "better to keep your mouth shut than to open it, than look like a fool" I cant imagine why she would say that to me. Maybe she's onto something! Take care all, Anthony M. Caruso NREMT-P -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Moore, Rick Sent: Thursday, October 12, 2006 10:37 AM To: Trauma & Critical Care mailing list Subject: RE: ATLS training Dr. Gross, Possibly I am missing something here, but I have looked into ATLS on many occasions from various providers and I have been told that I may audit the course (as an RN or Paramedic) but that I will not be able to participate in the skills stations or competency testing. If this is not correct possibly the ATLS training programs need to refer to the ATLS manual. REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Ronald Gross Sent: Thursday, October 12, 2006 9:15 AM To: Trauma & Critical Care mailing list Subject: RE: ATLS training Rick, You are wrong - please refer to the ATLS manual. RIG >>> "Moore, Rick" <Rick.Moore at TriadHospitals.com> 10/11/2006 9:54 AM >>> Oh please!! A one weekend course is better than a multi year residency? Give me a break! And by the way in that rural environment that your talking about, the first responders won't be trained in ATLS, because a) they can't afford it and b) they aren't allowed to train in and perform the skills portions if they do come up with the money. REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Juan Duchesne Sent: Tuesday, October 10, 2006 4:53 PM To: trauma-list at trauma.org Subject: RE: ATLS training ATLS save lives.......end of discussion guys!......this is not about a certificate, audit, CME or waste of time.....this is about personal commitment in doing what is best for patient care.......We need to stop this attitude about what ATLS really means.........I will like to read any LEVEL I EVIDENCE THAT ANY residency ED,SURGERY..... IS EQUAL OR BETTER THAN ATLS TRAINING........if any question place YOURSELF OR YOUR FAMILY in a rural environment where your first responder is not ATLS trained.......I HAVE BEEN THERE!!!.....AND IS NOT FUN OR FAIR!........END OF DISCUSSION! Let's move on. juan Juan C Duchesne, M.D. University of Mississippi Medical Center Assistant Professor of Surgery/Trauma and Critical Care Louisiana ATLS State Faculty 2500 North State Street Jackson MS 39216 >>> Rick.Moore at TriadHospitals.com 10/10/06 12:55 PM >>> Since when is an off-duty physician who happens to be driving by or otherwise in the neighborhood "duty bound" to respond and assist? REM -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Patrick Greiffenstein Sent: Tuesday, October 10, 2006 12:42 PM To: trauma-list at trauma.org Subject: Re: ATLS training I agree with Dr Duchesne. ATLS is a basic skills course that is not very demanding to take and would benefit ANYONE being involved with any patient. Given the fact that we might come accross a trauma scene outside of the hospital (I've counted three since I graduated med school four years ago!) and the fact that we as physicians are duty-bound to respond, it is a course that every physician should take in an ideal world. One would think that practicing MDs would be well acquainted with most of the basics covered by ATLS. As an ATLS instructor I can tell you that it is absolutely frightening how many general surgeons and ED-program graduates, not to mention orthopods, FP's, internists and others who have opted to take our course that have clearly no clue what the basics are (this is AFTER several hours of lecture on the subject). I believe that too much rides on a smoothly-working trauma team and that redundancy, when feasible, can avert disaster. If everyone knows what everyone else is supposed to be doing, things might be missed or overlooked less often. Given the stakes and the time-constraints, I think a little weekend course twice every decade is a miniscule price to pay. my 1.5 cent's worth -Patrick Greiffenstein Resident, General Surgery LSUHSC, New Orleans pgreif at lsuhsc.edu On 10/6/06, trauma-list-request at trauma.org <trauma-list-request at trauma.org > wrote: > > Send trauma-list mailing list submissions to > trauma-list at trauma.org > > To subscribe or unsubscribe via the World Wide Web, visit > http://list.mistral.net/mailman/listinfo/trauma-list > or, via email, send a message with subject or body 'help' to > trauma-list-request at trauma.org > > You can reach the person managing the list at > trauma-list-owner at trauma.org > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of trauma-list digest..." > > > Today's Topics: > > 1. Re: ATLS for consultants... (Juan Duchesne) > 2. Re: ATLS for consultants... (Ronald Simon) > 3. Re: ATLS for consultants... (Jago Miloguz) > 4. RE: ATLS for consultants... (Hotz, Heidi, RN) > 5. Re: ATLS for consultants... (Ronald Gross) > 6. Re: ATLS for consultants... (Ronald Gross) > 7. NoM Spleen Returns (Bjorn, Pret) > > > > ---------- Forwarded message ---------- > From: "Juan Duchesne" <JDuchesne at surgery.umsmed.edu><~!B*+R^&>> To: <rfsmithmd at comcast.net>, <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 08:59:51 -0500 > Subject: Re: ATLS for consultants... > I strongly disagree with your statement Dr. Smith. I work in that > same enviroment you are describing were our ED staff refuse to do > ATLS, their explanation is that ED training (3-4 years) and recert (q > 10 years) equalls ATLS (2 days q 4 years)......we are just asking 2 DAYS for cert. > and one day for recert.!!!! how bad can that be for GOD > sake!!!.............. This is not about MD ego's Dr Smith........this > is very simple and clinically demostrated: ATLS DEFINITIVELY IMPACT > PATIENT CARE!!....let all jump on the boat and work as a > team!........As for consultants even if they are not first responders > to activation we still mandate they get their ATLS. > juan > > Juan C Duchesne, M.D. > University of Mississippi Medical Center Assistant Professor of > Surgery/Trauma and Critical Care 2500 North State Street Jackson MS > 39216 > >>> rfsmithmd at comcast.net 10/06/06 2:32 AM >>> > I am a huge fan of ATLS but I am curious as to the rational for > requiring consultants OR primary trauma providers to have taken ATLS. > How will this positively impact the care of the injured patient? > Hopefully the consultants will not be directing the resuscitation or > initial evaluation of the patient. Conversely ATLS will not have a > meaningful impact on the experience of trauma providers compared to a > full residency in either surgery or emergency medicine. > > R. Smith MD > > -------------- Original message -------------- > From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>><~!B*+R^&>> > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, > > etc) should be required to have taken ATLS to care for a trauma pt. > > The question is whether this should be part of the requirements for > > trauma > > > center designation. No question that members of the trauma service > > and > > > the ED should but what about the subspecialists? Sure its a good > concept > > but actually getting them to take it is another thing. What is the > > practice of other trauma systems? > > Thanks > > Ron Simon, MD > > Jacobi Medical Center > > Bronx, NY > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > ---------- Forwarded message ---------- > From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>> To: "Trauma & Critical Care mailing list" < > trauma-list at trauma.org> > Date: Fri, 06 Oct 2006 11:15:20 -0400 > Subject: Re: ATLS for consultants... > The thoughts behind requiring consultants to take the course is for > them to understand how we prioritize and why we may ask them to go > away and come back later. ron simon > > rfsmithmd at comcast.net wrote: > > >I am a huge fan of ATLS but I am curious as to the rational for > >requiring > consultants OR primary trauma providers to have taken ATLS. How will > this positively impact the care of the injured patient? Hopefully the > consultants will not be directing the resuscitation or initial > evaluation of the patient. Conversely ATLS will not have a meaningful > impact on the experience of trauma providers compared to a full > residency in either surgery or emergency medicine. > > > >R. Smith MD > > > >-------------- Original message -------------- > >From: Ronald Simon <Traumamd at nyc.rr.com><~!B*+R^&>> > > > > > > >>We are currently having a debate in our State Trauma Advisory > >>Committee about whether trauma related consultants (neurosurg, > >>ortho, ent, etc) should be required to have taken ATLS to care for a > >>trauma pt. The question is whether this should be part of the > >>requirements for trauma center designation. No question that members > >>of the trauma service and the ED should but what about the > >>subspecialists? Sure its a good concept but actually getting them to > >>take it is another thing. What is the practice of other trauma systems? > >>Thanks > >>Ron Simon, MD > >>Jacobi Medical Center > >>Bronx, NY > >> > >>-- > >>trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > >>settings or unsubscribe visit: http://www.trauma.org/traumalist.html > >> > >> > >-- > >trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > >or unsubscribe visit: > >http://www.trauma.org/traumalist.html > > > > > > > > -- > Ronald Simon, MD > Dir of Trauma/SICU > Jacobi Medical Center, Rm 1213 > Bronx, NY 10461 > 718 918 5598 phone > 718 918 5593 fax > > > > > > ---------- Forwarded message ---------- > From: "Jago Miloguz" < japrak at gmail.com> > To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 6 Oct 2006 17:58:49 +0200 > Subject: Re: ATLS for consultants... > well it would be ideal to have everybody who gets in touch with trauma > patient pass the ATLS but obviously it is quite irrational to wish, > but l think it should be officialy mandatory for all personal dealing > with to intiative managment of trauma patients to pass ATLS(EM docs > and acute care and trauma surgeons).if every hospital has those docs > with passed ATLS then patients would probably do just fine with > consultants not passing ATLS. just my opinion > ante > > > 2006/10/6, Ronald Simon <Traumamd at nyc.rr.com>:<~!B*+R^&>> > > > The thoughts behind requiring consultants to take the course is for > > them > > > to understand how we prioritize and why we may ask them to go away > > and come back later. > > ron simon > > > > rfsmithmd at comcast.net wrote: > > > > >I am a huge fan of ATLS but I am curious as to the rational for > requiring > > consultants OR primary trauma providers to have taken ATLS. How will > this > > positively impact the care of the injured patient? Hopefully the > consultants > > will not be directing the resuscitation or initial evaluation of the > > patient. Conversely ATLS will not have a meaningful impact on the > experience > > of trauma providers compared to a full residency in either surgery > > or emergency medicine. > > > > > >R. Smith MD > > > > > >-------------- Original message -------------- > > >From: Ronald Simon <Traumamd at nyc.rr.com > > > > > > > > > > > > >>We are currently having a debate in our State Trauma Advisory > Committee > > >>about whether trauma related consultants (neurosurg, ortho, ent, > > >>etc) should be required to have taken ATLS to care for a trauma > > >>pt. The question is whether this should be part of the > > >>requirements for trauma center designation. No question that > > >>members of the trauma service and > > > >>the ED should but what about the subspecialists? Sure its a good > concept > > >>but actually getting them to take it is another thing. What is the > > >>practice of other trauma systems? > > >>Thanks > > >>Ron Simon, MD > > >>Jacobi Medical Center > > >>Bronx, NY > > >> > > >>-- > > >>trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > >>settings or unsubscribe visit: > > >>http://www.trauma.org/traumalist.html > > >> > > >> > > >-- > > >trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > >settings or unsubscribe visit: > > >http://www.trauma.org/traumalist.html > > > > > > > > > > > > > -- > > Ronald Simon, MD > > Dir of Trauma/SICU > > Jacobi Medical Center, Rm 1213 > > Bronx, NY 10461 > > 718 918 5598 phone > > 718 918 5593 fax > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > > > > > > > ---------- Forwarded message ---------- > From: "Hotz, Heidi, RN" <Heidi.Hotz at cshs.org><~!B*+R^&>> To: 'Trauma &' < trauma-list at trauma.org> > Date: Fri, 6 Oct 2006 09:11:36 -0700 > Subject: RE: ATLS for consultants... > Ron, > > All of our EM physicians have completed ATLS once in their lifetime > (thus, we adhere to the ACS Gold Book criteria.) With regards to our > consultants from Ortho and Neurosurgery, it is not a formal > requirement, but we have some of them become ATLS Instructors because > they want to; believe it is their duty working at a Level I trauma > hospital; etc, etc. We have two orthopedic trauma surgeons that are > Instructors. We run two ATLS courses per year, so they only need to > teach once yearly. > > Our County trauma contract and State Regs do not require them to have > ATLS. > > Hope this helps. > > Best of luck. > > Heidi > > Heidi A. Hotz, RN, Trauma Program Manager Department of Surgery > Cedars-Sinai Medical Center 8700 Beverly Blvd. Los Angeles, CA 90048 > > Office: 310-423-8732 > Cell: 310-430-2649 > Pager: 310-960-6341 > Fax: 310-423-0139 > > -----Original Message----- > From: trauma-list-bounces at trauma.org > [mailto:trauma-list-bounces at trauma.org > ] > On Behalf Of Ronald Simon > Sent: Thursday, October 05, 2006 6:16 PM > To: trauma-list at trauma.org > Subject: ATLS for consultants... > > We are currently having a debate in our State Trauma Advisory > Committee about whether trauma related consultants (neurosurg, ortho, > ent, etc) should be required to have taken ATLS to care for a trauma > pt. The question is whether this should be part of the requirements > for trauma center designation. No question that members of the trauma > service and the ED should but what about the subspecialists? Sure its > a good concept but actually getting them to take it is another thing. > What is the practice of other trauma systems? > Thanks > Ron Simon, MD > Jacobi Medical Center > Bronx, NY > > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > ---------- Forwarded message ---------- > From: "Ronald Gross" < Rgross at harthosp.org> > To: <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 12:20:12 -0400 > Subject: Re: ATLS for consultants... > Ron, > > We require that ortho and neurosurgeons take ATLS at least once. > > Please note that the ACS COT "Optimal Resourses" document states that, > "At a minimum, orthopaedic surgeons on the trauma team should be > encouraged to successfully complete an ATLS Student Course." The same > statement is repeated in the neurosurgical chapter: "At a minimum, > neurosurgeons on the trauma team should be encouraged to successfully > complete an ATLS Student Course." > > Best wishes, > Ron > > >>> Ronald Simon <Traumamd at nyc.rr.com> 10/5/2006 9:16 PM >>> > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, etc) > should be required to have taken ATLS to care for a trauma pt. The > question is whether this should be part of the requirements for trauma > > center designation. No question that members of the trauma service and > > the ED should but what about the subspecialists? Sure its a good > concept but actually getting them to take it is another thing. What is > the practice of other trauma systems? > Thanks > Ron Simon, MD > Jacobi Medical Center > Bronx, NY > > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > > > > ---------- Forwarded message ---------- > From: "Ronald Gross" < Rgross at harthosp.org> > To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org><~!B*+R^&>> Date: Fri, 06 Oct 2006 12:25:41 -0400 > Subject: Re: ATLS for consultants... > The concept is to ensure that the subspecialists see, learn about and > understand the overall picture of trauma care, how the concept of a > systems/team approach to trauma care actually includes them, and that > they should incorporate it into their lexicon....... > > >>> <rfsmithmd at comcast.net> 10/6/2006 3:32 AM >>> > I am a huge fan of ATLS but I am curious as to the rational for > requiring consultants OR primary trauma providers to have taken ATLS. > How will this positively impact the care of the injured patient? > Hopefully the consultants will not be directing the resuscitation or > initial evaluation of the patient. Conversely ATLS will not have a > meaningful impact on the experience of trauma providers compared to a > full residency in either surgery or emergency medicine. > > R. Smith MD > > -------------- Original message -------------- > From: Ronald Simon < Traumamd at nyc.rr.com> > > > We are currently having a debate in our State Trauma Advisory > Committee > > about whether trauma related consultants (neurosurg, ortho, ent, > > etc) > > > should be required to have taken ATLS to care for a trauma pt. The > > question is whether this should be part of the requirements for > trauma > > center designation. No question that members of the trauma service > and > > the ED should but what about the subspecialists? Sure its a good > concept > > but actually getting them to take it is another thing. What is the > > practice of other trauma systems? > > Thanks > > Ron Simon, MD > > Jacobi Medical Center > > Bronx, NY > > > > -- > > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your > > settings or unsubscribe visit: http://www.trauma.org/traumalist.html > -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > > > > > ---------- Forwarded message ---------- > From: "Bjorn, Pret" <pbjorn at emh.org><~!B*+R^&>> To: < trauma-list at trauma.org> > Date: Fri, 6 Oct 2006 12:18:52 -0400 > Subject: NoM Spleen Returns > Adult female MVC. Left rib fx's 10-12, known splenic inj, read as > Grade I in spite of contrast blush (not intended as the thrust of this > thread). > > The patient was admitted for two nights, stable throughout, and > discharged with her cooperation and enthusiasm. She was prescribed > house arrest for a week, drastically limited activity, and an office > visit to follow. > > As fate would have it, on post-injury day 6 she suffered a sudden > sharp LUQ pain with what sounds like a brief vagal response. She > reported immediately to her local ED, where another CT shows both a > persistent blush plus intraperitoneal hemorrhage (second image). > > At the local hospital, vitals were stable (she was in fact > hypertensive consistent with her medical history) and her labs were > unremarkable (H&H 12 and 35, roughly identical to previous discharge > numbers). She was > admitted to the local hospital for observation, but her counts slipped > overnight (10 & 27), and so she was transferred back to us. She > arrives stable and without any major complaints. Even a little hungry. > > Interested in what others would plan for her. Observe? Coil? Both? > Other? > > Pret Bjorn, RN > > > <<FirstImage.jpg>> <<SecondImage.jpg>><~!B*+R^&>><~!B*+R^&>><~!B*+R^&>> -- > trauma-list : TRAUMA.ORG <http://trauma.org/> To change your settings > or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html ------------------------------ Message: 4 Date: Fri, 13 Oct 2006 10:51:39 EDT From: Krin135 at aol.com Subject: Re: ATLS training To: trauma-list at trauma.org Message-ID: <cbb.a059d3.326101fb at aol.com> Content-Type: text/plain; charset="US-ASCII" In a message dated 10/13/2006 9:33:25 AM Central Standard Time, Rick.Moore at TriadHospitals.com writes: Cool, Thanks for that info. I am also looking at the CALS course that someone mentioned on here during the discussion as well. And I agree, if a medical professional on scene is actually helping, they are more than welcome to stick around. Rick _www.c_ (http://www.c) _alsprogram.org_ (http://www.alsprogram.org) or the link from the Minnesota Academy of Family Physicians at _www.mafp.org_ (http://www.mafp.org) ck Charles S. Krin, DO FAAFP ------------------------------ Message: 5 Date: Fri, 13 Oct 2006 10:56:14 EDT From: Krin135 at aol.com Subject: Re: ATLS training To: trauma-list at trauma.org Message-ID: <c31.57783ab.3261030e at aol.com> Content-Type: text/plain; charset="US-ASCII" In a message dated 10/13/2006 9:52:27 AM Central Standard Time, Krin135 at aol.com writes: _www.c_ (http://www.c) _alsprogram.org_ (http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2006-October/_http://www.alsprogram.org_ (http://www.alsprogram.org) ) make that _www.calsprogram.org_ (http://www.calsprogram.org) ck ------------------------------ Message: 6 Date: Fri, 13 Oct 2006 14:44:02 -0700 From: "Mike" <mmackinnon at cox.net> Subject: Re: The ATLS evidence argument To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org> Message-ID: <005901c6ef10$b3525370$6701a8c0 at booty2> Content-Type: text/plain; format=flowed; charset="iso-8859-1"; reply-type=original Thanks Ron Appreciated ;) ----- Original Message ----- From: "Ronald Gross" <Rgross at harthosp.org> To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org> Sent: Friday, October 13, 2006 4:09 AM Subject: Re: The ATLS evidence argument > Karim, > > I guess we really should have stopped yesterday. > > Mike, please contact Irvene Hughes at the ACS ATLS office > (ihughes at facs.org). She has been with the ATLS program since its > inception in 1980, and am certain that she will have all of the data > that you wish to see re: the effectiveness of that course in improving > patient care. Then perhaps you could share that information with all > who want to see the evidence (but only if you want to....), and either > refute those with the "double standard" or publically admit that those > "dogmatic beliefs" just might have been supported by statistics and a > well-designed program that was, and continues to be scrutinized, > analyzed, and redone by some pretty good educators over the last 26 > years. > > No one has ever said that ATLS has provided us with the one and only > correct way to take care of the trauma patient, and, as previously > pointed out, the course text specifically states that. What it does > do is provide all who take it with a BASIC understanding of the > disease we call trauma, and provides us with a guide as to how to > approach the trauma patient when they present to your shop. The > course provides, simply speaking, a "common language" with some common > goals of therapy that are common to all patients who are injured and > need care. Simple concept, simple goal, huge results. (sorry for the > opinionated conclusion at the end of that sentence.....I just couldn't > resist!! :-) > > Best to all, > Ron > > Gotta go for a while - actually gonna venture into the OR (if I can > find it....) WOW, what a great day! > >>>> "Mike" <mmackinnon at cox.net> 10/12/2006 10:07 PM >>> > To all > > I have to admit im quite disappointed by the reaction to Dr Paul > Bailey's query for evidence. Over the 7 years ive been apart of this > list, Ive seen over and over many people "challenge" for evidence of a > practitioners opinion or assumptions. Not only has this made me a > better provider, but has caused me to become involved in research as > well as publication. Evidence based medicine/practice is the goal we > all strive for. > > To see many of those who have traditionally challenged for evidence > all of a sudden propagate dogmatic beliefs in response, is > disheartening. It suggest that there is clearly a double standard > which should not exist. Based on the discussions over the years, the > general consensus is that there is nothing that "just makes sense" or > is "self evident" in the realm of evidence based medicine. Odd to read > those very things said now by those who have scorned others in the > past. > > Essentially. Prove it or don't do it, as Dr Mattox says. > -- > trauma-list : TRAUMA.ORG > To change your settings or unsubscribe visit: > http://www.trauma.org/traumalist.html > > > > > -- > trauma-list : TRAUMA.ORG > To change your settings or unsubscribe visit: > http://www.trauma.org/traumalist.html > ------------------------------ Message: 7 Date: Fri, 13 Oct 2006 20:43:04 -0500 From: "Charlene M Morris" <cvmmorris at gmail.com> Subject: Nice. To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org> Message-ID: <ca095570610131843j30b2830xc03bc898a74ad975 at mail.gmail.com> Content-Type: text/plain; charset=ISO-8859-1; format=flowed http://www.acep.org/webportal/membercenter/periodicals/an/2006/sep/hero.htm C M Morris ------------------------------ -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html End of trauma-list Digest, Vol 40, Issue 25 ******************************************* ________________________________________________________________________ NHSi Awards, rewarding excellence in health and social care - apply or nominate before 31st October http://www.doctors.net.uk/HSCAwards _______________________________________________________________________ -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/traumalist.html
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