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Fri Aug 17 16:34:44 BST 2007

Hi Rob,

Looks like you and I are gonna disagree for (I believe) the first time.

The fact is that they CAN - or rather let me say that as a Level III Trauma Center, they SHOULD without a doubt have the ability to care for this patient.  Cold steel to the abdomen, spleen in a bucket, pack the abdomen and then send the patient who most likely is now hemodynamically stable after about one hour OR LESS in the OR.  

No screwing around, no VOMIT, no x-rays or angios, just an incision.  If they don't have an OR or a surgeon, then, to repeat what has already been said, the hospital and the system are broken beyond belief; the system doesn't exist and the hospital is merely an outpatient clinic.

My turn to say IMHO!  ;-)

Take care, Rob!  Give my best to your better half!

Ron

>>> "Robert F. Smith" <rfsmithmd at comcast.net> 8/17/2007 10:43 AM >>>

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. 

Ron,

I totally disagree with this. IMHO as soon as it is clear that the original
hospital will not or cannot adequately care for the patient transfer
immediately. If it is me or my loved one please do not "stabilize" first.
Stabilize = screwing around with crystalloid and blood and VOMIT till death
or further decompensation. Please put me in a fast ambulance and send me to
the hospital that is willing and able to immediately care for my injuries.

Rob

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