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Fri Sep 7 03:24:46 BST 2007

In a message dated 9/6/2007 9:17:58 P.M. Central Daylight Time, ih7 at msn.com  
writes:

pulse:  weak   CNS status: poor    NIR : low O2 delivery   Urine output:  low 
to none   Skin color& temp:  pale, cold.
Primary Survey,   Secondary Survey.  Look for causes of the  above.    In our 
institution, this patient would have gone from  ER ambulance loading dock to 
the OR in less than 3 minutes, and look for just  what to do in the OR.     He 
would NOT get a sub xyphoid  pericardial window.   If it was obvious that 
there was no site of  blood loss in the abdomen or pleural cavity or externally, 
and he was the  patient we all have been talking about the last hour, I would 
cut his chest via  a 4ICS anteriorlateral incision about 6 minutes after he 
arrived at the  hospital.    

k

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