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Sun Jun 10 13:42:23 BST 2007

Thanks for your reply Tim.

--
Kind regards,
Phil
Phil Caropreso, MD, FACS
1813 Grand Avenue
Keokuk, Iowa, USA, 52632
pjcabdds at mchsi.com

----------------------  Original Message:  ---------------------
From:    "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za>
To:      "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Subject: RE: EMS management/crush injury
Date:    Sun, 10 Jun 2007 05:39:39 +0000

> Phil
> 
> We need more info - but if it has decreased time to definitive care (i.e. your 
> hospital would refer on) then there is no major critique. Having said that you 
> did have a team on standby and since this was a lim-only injury by description, 
> may have been managed by you definitively. Would take this up with the 
> EMS-medical director, since this would constitute an EMS crew overriding their 
> Medical Control (you - they put you on standby; you should make the call!). 
> Having said all this I'm in another country, with different rules!
> 
> Tim
> Dr T C Hardcastle
> M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
> Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
> ATLS  instructor and DSTC Cape Town Course Director
> Intern program Coordinator: Surgery
> M.Med (Emergency Medicine) Executive Committee member
> Clinical Head (Director): Diana Princess of Wales Trauma Unit
> Division of Surgery (General) Room 4064
> Department of Surgical Sciences
> Tygerberg Hospital / University of Stellenbosch
> PO Box 19063
> Tygerberg 7505
> Western Cape
> South Africa
> e-mail: tch at sun.ac.za
> Cell: +27824681615
> Office: +27219389281 or 4911 pager 0302
> 
> 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of pjcabdds at mchsi.com
> Sent: Saturday, June 09, 2007 11:06 PM
> To: trauma-list at trauma.org
> Subject: EMS management/crush injury
> 
> 
> Colleagues, 
> Opinions, comments, analysis, advice would be appreciated on the pre-hospital
> management of this case: 
> Adult woman, driver of a motorcycle, which was stopped at an intersection in
> town (10,000 pop). Seven blocks from the hospital. A semi truck, hauling a
> bulldozer type, heavy equipment, pulled up along side of the motorcycle.
> Restraining chain broke and the implement fell off of the truck, crushing the
> woman's right leg beneath the tread of the equipment. Unable to get VS. IV
> started. Patient awake. At least 30 minute extrication. Local, ground EMS advise
> trauma alert. A full trauma team (boarded ERP, GS, anesthesia, OR crew) all in
> house and waiting for patient. A helicopter was dispatched to the hospital for
> likely transfer, after local evaluation and stabilization, to tertiary center,
> 45 air minutes away. Ground EMS personnel diverted the helicopter to the scene.
> The patient was transferred from the site. I have no other details.
> I will present this case at the local trauma committee meeting. I am looking for
> help in organizing my thoughts. Thank in advance. 
> 
> --
> Kind regards,
> Phil
> Phil Caropreso, MD, FACS
> 1813 Grand Avenue
> Keokuk, Iowa, USA, 52632
> pjcabdds at mchsi.com
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