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Fri Sep 7 02:02:41 BST 2007

I had intended to watch and learn, but I can no longer remain  silent.    My 
fear is that the unprepared mind might become  confused by this discussion, or 
even might make the evaluation of cardiac injury  more difficult.    I am 
very concerned that the focus is now on  technology and not the patient.  EVERY 
technology can be helpful and can be  a VOMIT. 

1.  WHY in the name of whatever is decent and honorable, why are  we trying 
to make things more difficult.      

2    FAST is helpful (if the test is POSITIVE) to  suggest hemopericardium, 
but NOT diagnosic of any real clinical condition unless  the test coorelates 
with the clinical findings.     PERIOD.     

3.    ANY ECHO (TTE, TEE, 2D, 3d, ETC. ETC. ) is a  RANDOM NUMBER GENERATOR 
and creates more problems, including increasing the cost  of care, much more 
than it is worth.   The risk benefit ratio is just  not worth it.    TEE is a 
test suggested by someone who needs  some way of making a living because they 
have no other skills that this  particular patient needs.   There are some 
narrow indications and  benefits for TEE, but this and use of TEE for potential 
aortic injury are just  not among those indications 

4.    For trauma, TEE is a massive, MASSIVE  VOMIT.   Enough said on this 
subject.  

k

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2D or 3D TEEin penetrating cardiac injury No NO