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Mon Dec 31 12:14:27 GMT 2007

There was NO extracation problem. The back seat space was not deformed

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-----Original Message-----
From: Mike Smertka <medic0947969 at yahoo.com>

Date: Mon, 31 Dec 2007 03:08:08 
To:"Trauma &amp, Critical Care mailing list" <trauma-list at trauma.org>
Subject: Re: British Surgeon: "Princess Diana might have survived if treated
	faster"

Please entertain me being the devil's advocate,

  If I understand this thread correctly a review of the treatment 10 years later over 2 countries, somebody decides she may have been savable? Just for my simplicity: high speed rendezvous with inanimate object, prolonged extrication, prehospital cardiac arrest. Does anyone believe it would have turned out differenty? Has anyone ever seen anyone recover from that? As an alternative reality, lets say she was transported to the hospital promptly. Do any of us actually believe that she would have woken up? Would we now be discussing whether 10 years on it was time to pull the plug? 

  Now I am willing to stipulate that if the princess was a 20 year chronic alcoholic, and crashed head on at 70+ mph into a minivan carrying the Beaver family, on their way home from church, she probably would have walked away. But absent crashing into the hospital door, being ejected onto the gourney, where the trauma team was just having a meeting, what is the blunt cardiac arrest survival rate today? Much less ten years ago? In any country in the entire world?

  Why don't these people just let her rest in peace. In another 10 years we can look at it again, and the facts will be altered just enough that we could create a reasonable theory she was killed by the same people as JFK. 

  But to defend the French for a minute. Some years back (prior to this event) I was having a discussion about the US prehospital system compared to that in France. During the discussion it was brought up that the measure of what makes one successful is different. What if the goal is not to flood the emergency room with every patient who calls? What if the goal is to reduce the cost of emergency care? What if you have to take into account what will help the most people even if some are considered acceptable losses? Hopefully nobody measures their system on the survival to discharge of trauma arrests. But please consider, if you bring all the equipment you can and a few people with you, what really is the difference if your hospital is on wheels or you are thrown into a pickup truck to the hospital? It seems to me what you need is a surgeon with some equipment, the venue is really trivial. MASH hospitals were basically tents. Nobody would argue they were beneficial. More
 over, lets stipulate somebody tossed her in a car and drove as fast as they could with due regard for public safety. We might be arguing that not enough was done for her in the prehospital setting. 

  Forgive the conspiracy theory, but not one person outside of our little world have I heard say: "trauma kills people like Princess Diana, maybe we should put more resources into making sure we provide the best possible care to those who are injured so they will recover and live happily ever after." Has anyone set up or received money from the Princess Di memorial trauma charity? 

  I think the whole point behind this inquest is to sell another book or news paper. Read all about it! How I would have saved the princess looking back on it in hindsight! "In Western society people only get killed from bad judgement on TV." I hate having my picture taken by people I know, much less people i don't. But it is part of celebrety life. If you want the money and fame, then you have to accept people will pay for the picture of you doing the simplest things. 

  Just to throw in a war story, on my first day ever as an EMT, my first ever call was a multi casualty MVA. 6 people, 3 ejected dead at the scene, 3 flown without stopping for pressors to an outstanding trauma center with some of the best physicians I have ever met. All died, later it was determined only the driver had alcohol in his system. So for my cynicism, cause of death was getting in the car with a driver who had been drinking. the Rest is just the details of it. 

  The real question of the day, in 2017 will we be asking how Bhutto died? was it the skull fracture from the lever or a gsw? 

  Mike

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British Surgeon: "Princess Diana might have survived if treatedfaster"