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Sat Oct 13 17:41:20 BST 2007

I never thought of that, but then again, at our center, the  ED physicians are not involved with trauma patients (who meet activation criteria) at all.  The rare, VERY RARE, exception would be if the surgeon on-call were to take one to the OR and another hit the door before the back up surgeon could arrive.  Happens, but not often.

If we go back to the original post, to re-direct, the question as one of "how long should a seriously injured trauma patient be in the trauma bay" (paraphased, but accurate).  

"serious" may be user-defined inasmuch as there are different levels, of course.  Dr. Mattox has yet to present literature of evidence to support his 3-8 min time frame.  I respect the hell out of the man for his experience, candor and advancement of trauma surgery as we know it today.  But he wants evidence that backs CTA for aortic injuries...I want the same for time in the trauma bay.  Yes, there are ridiculously long stays that are unwarranted and dangerous.  But there are short stays that may be equally unwarranted and dangerous.

I submit this question to the list:  Is FAST considered a "standard of care" diagnostic tool in the level I trauma center...whether interpreted by the surgeon, surgery resident, radiologist/resident?  If you aren't doing it, are you practicing beneath the standard?  And, back to Dr. Mattox's response, how do you fit it into an 8 min trauma with ABC's, chest tubes, etc?

RRD
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