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Fri Aug 17 16:19:45 BST 2007

In a message dated 17-Aug-07 10:15:43 Central Daylight Time,  
Rgross at harthosp.org writes:

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

Ron, 

I got it the first time at 0917 local today.

and agree with what you, and the others are saying about stabilizing the  
patient with an emergent laparotomy and apppropriate  
packing/ligation/splenectomy....

Now if I could just recruit a surgeon to do that kind of work...small town  
hospitals do have some drawbacks.

ck
Charles S. Krin, DO FAAFP

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