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Sat Jul 21 14:35:18 BST 2007

I disagree.  

First, when somebody is suffering or endangered, it's utterly shameful for a
trained healer to shelter himself behind "it's not my job."  Such just
further encourages the unconscionable crap illustrated in Dr. Mattox's
scenario. 

Furthermore, the practice of emergency medicine is not confined to a disease
set; often, and "emergency" arises when a routine health issue is
complicated by non-routine circumstances -- like labor and delivery in a
mentally ill woman with no social support.  

Honestly, I think that an EM clinician (given the opportunity -- not clear
in Ken's story) would have been uniquely able cut through all the nonsense
of this case.  The obstetrician, the anesthesiologist, and the surgeon(?)
were clearly out of their environment and distracted by issues that
emergency docs have long since learned to handle.  

>From the available evidence, I'd suggest that this woman's real problems had
nothing to do with her pregnancy or her mental illness or her grandmother.
It's disturbingly easy to assume that those were all convenient excuses.
She made the mistake of going to a hospital where nobody cared.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of trauma at emergencyunit.com
Sent: Saturday, July 21, 2007 2:41 AM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: Table Top Test - CALL to you "an on call medical supervisor"

This story demonstrates a classic error that ED doctors are prone to making.
Trying to solve other people's problems. Leaving aside the pottiness of the
US payment and legal systems (here in the UK we have two laws that would
allow treatment of this person in an emergency and of course for free) an ED
doctor should not be trying to gain consent for either the anaesthetic nor
the delivery. He isn't going to do either procedure and is unlikely to be
able to gain valid consent from anyone! Let the OB answer his own questions,
get off his backside and deal with his patient. Ditto the anaesthetist
(anaesthesiologist). 

BFM

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Table Top Test - CALL to you "an on call medical supervisor"