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Sun Dec 9 15:50:01 GMT 2007

ISBN 1-903378-22-2
Hirshberg and Mattox
Top Knife.
The art and craft of trauma surgery.
I bought it at Amazon.

Nick Macartney 

> -----Original Message-----
> From: trauma-list-bounces at trauma.org 
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of 
> ðáíáãéþôçò âáãåíÜò
> Sent: 09 December 2007 12:34
> To: Trauma &amp; Critical Care mailing list
> Subject: (no subject)
> 
> Goodmorning from Greece.
> I am about to take the final exams as a specialist general surgeon.
> I have heard about a book called " Top Knife ".
> Please, if anyone knows some details about the edition, i 
> would be grateful 
> 
> Thanks
> 
> 
> 
> 
> ----- Message d'origine ----
> De : caesar ursic <cmursic at gmail.com>
> À : "Trauma &, Critical Care mailing list" 
> <trauma-list at trauma.org> Envoyé le : Dimanche, 9 Décembre 
> 2007, 7h44mn 52s Objet : Re: Trauma Systems & Centres
> 
> >  What is interesting, is what the fate of small trauma 
> centers will be.
> > If, for a mere reason of low volume, they cannot meet the 
> 'gold standard'
> > (assuming that we've adjusted for other confounders) should they be 
> > shut down or penalized?
> 
> 
> *A small trauma center that serves a large geographical area 
> (albeit probably sparsely populated) will never see enough 
> patients to meet any one of several proposed benchmarks, 
> given a stable increase in local population growth.  Shut 
> them down and you are now forcing local EMS agencies to 
> travel much greater distances to deliver the injured to the 
> 'nearest' trauma center.  So ask yourself these questions: 
> Can the local infrastructure support this?  More helicopters, 
> perhaps?  Will eliminating the local Level II or III facility 
> with 'low' numbers actually improve outcomes in these 
> patients who are now spending much more time in a 
> pre-hospital setting due to greater travel times to 
> definitive care?  Will the  'gold standard'
> destination trauma center cope well with the sudden increase 
> in the number of patients arriving at its door?  *
> 
> 
> > Or should we bite the bullet, send specialists to these centers and 
> > try to increase the volume?
> 
> 
> *Who is the 'we' of which you speak?  The American College of 
> Surgeons?   The
> local/state agencies that regulate trauma centers?  The 
> nearest University-affiliated teaching hospital?  The 
> military?  And how do you propose that trauma volume be 
> increased?  How will any given geographic area increase the 
> incidence / prevalence of serious injury, outside of inciting 
> riots and dispensing free tequila and Glocks outside bars?*
> 
> 
> > Finally, does meeting the 'gold standard' and becoming a center of 
> > excellence equal improved quality?
> 
> 
> *Ahh...well, that depends on whom you read.  Practice does 
> make perfect; the question is, how much practice? *
> 
> >
> >  KH
> >
> 
> *CMU*
> 
> --
> 'Twas brillig, and the slithy toves
> Did gyre and gimble in the wabe:
> All mimsy were the borogoves,
> And the mome raths outgrabe.
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