List Archives

Tue Jan 9 07:23:29 GMT 2007

John,
Not a small point if you are an "ER doc", and yes you are correct - the
original post did not say the flight doc was an ER doc.
;-)
Ron

>>> "John Holmes" <docjohnholmes at hotmail.com> 01/09/07 2:14 AM >>>
...............If this is accurate, the ER doc messed up

Maybe just a small point, but I don't believe the orignal post said
that 
this was an "ER doc".

John

Dr John L Holmes
Director Emergency Medicine
Mater Adult Hospital
Brisbane, Australia

>From: bensonblues at comcast.net 
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: trauma-list at trauma.org 
>Subject: Re: "emergency cricothyrotomy" Date: Tue, 09 Jan 2007
06:15:20 
>+0000
>
>LanceO Oosthuizen <LanceO at sedibeng.gov.za> wrote:
>   Hi All I am an ALS paramedic from SA just south of Johannesburg.
Just 
>recently I
>received a call of a male patient 29 who came off a quad bike in a
remote 
>area
>
>Lance,
>
>Ouch! You paint an ugly picture. If this is accurate, the ER doc
messed up 
>and you proved it to him and everybody else. His training and
experience 
>needs to be reviewed by somebody responsible for him. There may or may
not 
>be a problem with the physician, in that we all have knowledge gaps
that 
>need to be filled. He found his, and now he has an opportunity to fix
it.
>
>I would move to obtaining a surgical airway only if the patient is
hypoxic 
>and difficult to ventilate, or, if I have reason to suspect that this
will 
>rapidly occur due to some clinical situation (maxillofacial injury
with 
>hemorrhage). Nonetheless, I would have someone else continue to
ventilate 
>and attempt to intubate while I was performing the procedure, and I
would 
>abort the cric if intubation was successful. Did this just the other
day, 
>in fact. I felt kind of stupid having to consult surgery to close the

>incision, but...if my colleague was unable to get the tube, well, you
see 
>the dilemna that we are faced with in airway problems. Hypoxia is so 
>unforgiving.
>
>DB
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