List Archives

Fri Aug 17 16:18:47 BST 2007

The original got through, at least to me.  

One of the idiosyncrasies of the List is the inconsistency (<1%) of
messages that don't come back after you send them.  Happens to me every
month or two.  Welcome to the club.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Ronald Gross
Sent: Friday, August 17, 2007 11:15 AM
To: trauma-list at trauma.org
Subject: Looks like this post never went through.....

NO!!

The level I Trauma Center has the responsibility to accept an unstable
patient only after the sending hospital has stabilized the patient to
the best of their abilities and cannot offer the patient anything
further. 

This patient's hypovolemic hemorrhagic shock is not due to the suspected
aortic tear, but rather due to the hepatic and splenic injuries which
require an emergent laparotomy with, at the very least
splenorrhaphy/splenectomy and damage control packing and then the
patient can be sent to the Level I Center.  All they need is an OR
9already ready) and a general surgeon who has (we hope) completed an
ACGME or other equivalent general surgical training program and who
still remembers how to operate WITHOUT a laparascope<

Just my 2 cents..........

Ron

>>> <ABMoss at aol.com> 8/16/2007 8:11 PM >>>

A question to the group.  Does a Level 1 Trauma Center have a
responsibility 
to accept an "unstable" patient from a Level 3 Trauma  Center?  30yr
male 
MVC, GCS 15, systolic BP 40-60. Resuscitation with  crystalloids and
PRBC.  CT 
revealed liver & spleen laceration and  suspected aortic injury. OR team
in 
house but no cardiothoracic  capabilities.  Level 1 Trauma Center is
about 15 
miles  away.

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Looks like this post never went through.....