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Fri Aug 17 01:57:24 BST 2007

This one will stir things up a bit...

My impression:  He's not unstable from the "suspected" Ao injury.  Unless he has a chest full of blood and obvious leak.  He's unstable from the liver/spleen...assuming that's what the CT seemed to show:? contrast extrav?

But I digress.  I think the Level III center, with inhouse OR staff and, presumably a general surgeon who can open an abdomen and pack or remove injured organs has the obligation to stabilize the patient.  We're not talking neurosurgery to evac a EDH/SDH and we don't even know that the Ao injury exists.

So, no, I don't think you're obligated AT THAT MOMENT.  They need to perform up to their abilities.  Even ATLS says this.

Others?

RRD
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