Traumatic aortic transections and stents

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Thanks Ian.

>>> "Ian Civil" <icivil at xtra.co.nz> 10/17/2007 5:23 AM >>>
Dear Ron,

We would too, as Karim knows from a presentation this last weekend. Haven't
done an open repair since 2005.

Is it the right thing to do? Well I suspect the horse is out of that stable.
Like so many things, clinical practice develops faster than the rigour of
clinical trials. Who knows. Might be like MAST trousers.

In the short term the patients do well, and in NZ and I suspect Australia we
have less difficulty capturing patients for followup (some are in fact
captured by Her Majesty which makes it easier). 

Ian Civil
Auckland

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] 
On Behalf Of Karim Brohi
Sent: Wednesday, October 17, 2007 10:02 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: Traumatic aortic transections and stents

Definitely!

On 15/10/2007, Ronald Gross <Rgross at harthosp.org> wrote:
> Folks,
>
> A straw poll:  would anyone on this list place an aortic stent in a 21
year old male with a femur fracture and a transection shown in the attached
ppt. ?
>
> Ron
>
> >>> "Ronald Gross" <Rgross at harthosp.org> 10/15/2007 9:43 AM >>>
> Through the medical staff, develop the position of medical bed manager
(aka bed czar) who will deal with such issues by simply admitting the
patient to the service where that patient most appropriately belongs.  Tends
to be a bit controversial at times, but for the most part, the attendings
will usually agree with the decision after the fact.  The entire process
MUST be subjected to PA/PI, and all "wrong" admissions need to be examined
so that all can learn.
>
> Ron
>
> >>> "Andrew J Bowman" <andrewj.bowman at gmail.com> 10/14/2007 10:49 AM >>>
> What then do we do about the attendings (fill in specialty here) who are
> reluctant to admit a patient without the complete workup????
>
> Andrew Bowman
>
>
>
> Of note, there is I believe a disturbing trend in emergency medicine
toward
> 'completing the workup' and perhaps this may explain some of the tendency
to
> keep patients in the ED for hours.
> Chuck Havel
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