List Archives

Fri Nov 30 16:11:29 GMT 2007

Below is an inquiry from Pret:

I am aware of the various sources of the various time quotes in the cited  
case.   The 11 hours comes from a vascular surgeon who was queried by  a 
reporter from USA Today.   The vascular surgeon, who I am aware does  almost no 
vascular trauma did give a response.      I  have no first hand knowledge of the 
times between wounding and hospital, time  between arrival and OR, and time in 
OR.   There is suggestions in  yesterdays paper that there were several hours 
between the ICU arrival and  death.    AND there is a suggestion of an alert 
interval to the  level to "squeeze a hand."   I do know the reputation of the 
hospital,  trauma center, and surgeons in that center and trust that the times 
were  appropriate for the judgment exercised by professionals.   Enough  said.  

Now on to Pret's question, I can only respond, not to a specific case, but  
to my own reflexes when highly visible patients, including physicians who are  
hurt come under my own care.  

1.    THere is always an extra awareness and  apprehension

2.    There are ALWAYS family, press, administrators,  and colleagues asking 
questions and making all sorts of un welcomed suggestions. 

3.    I ALWAYS have a reflex to over treat a VIP, or to  anticipate a therapy 
which I do not regularilly apply

4.    I have a reflex to use smaller chest tubes and  smaller NG tubes, and 
to get them out earlier.   BAD  reflex.   

5.    I am so aware of these reflexes, we actively talk  about them and 
ACTIVELY revert to treating all patients the same, regardless of  name, status, or 
press.   

k

In a message dated 11/30/2007 7:59:05 A.M. Central Standard Time,  
pbjorn at emh.org writes:

Further  pursuing the hypotheticals and scratching around for  informative
controversy:

Various media reports put this victim in  surgery for "several hours"
during the acute phase (I've heard as few as  seven and as many as
eleven).  I'm wondering why damage control for  this injury in an
unstable patient would extend beyond tens of  minutes.

Takes me back to the child in Florida who had his arm ripped  off by a
shark some years ago: arrived in extremis, reportedly coded once  or
twice, but nonetheless underwent something like eight hours of  surgery
to reattach his arm.

Is there something about Taylor's  injury that might require an
improbably LONG life-saving procedure -- or is  it possible that everyone
got too invested in that leg?

Pret Bjorn,  RN
Bangor, ME USA

**************************************Check out AOL's list of 2007's hottest 
products.
(http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001)

List Archives

For your convenience, find the Trauma List Archive Below

Injury & VIPs