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Sat Oct 13 21:46:42 BST 2007

Roy,

If your ICU nurses and OR nurses are as bad as you are making them out
to be, you have more problems then just the time you are spending in the
Trauma Resus. Room.  I think that Ken is perfectly capable of speaking
for himself, but I gotta tell you that I don't think that he is saying
that the trauma team should be disbanded - just used appropriately.  And
so should the rest of the hospital!

Ron (NOT Mattox - though I wouldn't mind being half as smart)

>>> Roy Danks <roydanks at hotmail.com> 10/13/2007 4:29 PM >>>
define "keep". What is the units time for "keep"?  Are we back to the
3-8 minutes?

And, I never heard back on how far your ORs are from the bumper of the
ambulance.  It's a valid question.  Our trauma bay is about 20, maybe 30
ft (I'm on tonight, I'll measure it)....it takes 30 seconds to get there
and maybe a minute to the cart total.

Chest tube = 3 min
Chest x-ray = 3-5 min*
FAST = 2 - 3 min
Pelvis x-ray = 3-5 min*

*= time to shoot, develop and pull up on the screen.
We usually know some vitals by then and have a great idea of stability
or lack thereof.

But, as I was thinking about this last night, I thought about how much
I wouldn't want to move a barely assessed pt to the OR or ICU where the
nurses are less familiar with placement of chest tubes, etc.  And, to a
smaller room (ICU) where you want to pack in someone with an ultrasound,
a portable x-ray machine...someone to do the foley, the RT to set up the
vent...

Honestly, Ken, are you suggesting that the trauma team as we know it
should be disbanded in favor of taking a "seriously injured" patient to
a patient care area that doesn't do trauma assessments, etc?  I think
this is absurd.  

Our trauma nurses are very well versed in set up of chest tube sets,
getting labs, etc, etc.  Why would you not use these folks to their
fullest potential?  Why would you move an unstable patient to an
unstable area?

ambulance
bumper<----------------------------------------FT----------------------------------->OR

Waiting, kind sir.

RRD

> From: Krin135 at aol.com> Date: Sat, 13 Oct 2007 15:03:01 -0400> To:
trauma-list at trauma.org> Subject: Re: Ideal ED length of stay?
(information & communications support)> > > In a message dated 13-Oct-07
11:48:53 Central Daylight Time, KMATTOX at aol.com > writes:> > For an
emergency room to keep ANY patient who obviously requires admission, > >
is not the best use of the resources in that location, whether it be a >
critical trauma patient, a heart attack, or a pneumonia. If it is
obvious > as to > where the patient should go (trauma goes to a surgical
service, either OR, > floor, or ICU), then that patient can get the
FAST, etc, at that secondary > location and aid in the overcrowding of
the EC. > > k> > > > Which is absolutely fine for a major University
Center...but not the > situation for a smaller (sometimes much smaller)
facility, where the EP is often the > only doc in house.> > ck> Charles
S. Krin, DO FAAFP> > > > ************************************** See
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