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Tue Apr 22 18:00:48 BST 2008

Replies below to Dr Myers comments... 

-----Original Message-----
From: Jeff Myers, D.O., Ed.M. [mailto:myersj at alum.rpi.edu] 
Sent: Tuesday, April 22, 2008 12:38 PM
To: Jeffery Hammond
Cc: 'Trauma &amp; Critical Care mailing list'; 'CCML'
Subject: Re: [ccm-l] RE: Rectal Exam Lawsuit DENIED

Remember all, we are getting the lay press' report of the events and
armchair quarterbacking the incident.  

	   -->>Agreed

All I glen was that this patient was struck in the head at a construction
site.  Was the treating team concerned about a head and c-spine injury?  

        -->> You don't need a rectal exam for an injury limited to the head
in a patient moving all 4 extremities.

Were they concerned the patient was combative / ? altered from the head
injury?  

	  -->> He was apparently talking to them. He didn't become combative
until they tried  to bugger him.

The patient was not only sedated but intubated (according to the
description) - doesn't this scenario occur across the country when we are
taking care of altered trauma patients so we can obtain timely imaging and
intervene rapidly? 

	  -->> Yes, in heavily intoxicated patients or those with major TBI.
But, in this case (agreeing that we have only part of the data) I would
counsel any trauma team member who intubated a patient just to do a rectal
exam.

I just ask you all to reflect on situations where you may have done the same
thing as reported because you were doing the right thing for the patient
before passing judgment in a situation where we have very limited
information.

	   -->> Gee, I didn't hear any indignation about "passing judgment
in a situation where we have very limited information" directed towards the
other comments that were uniformly condeming lawyers and praising the "good
guys." 

Jeffrey Hammond MD, MNPH
New Brunswick, NJ

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[ccm-l] RE: Rectal Exam Lawsuit DENIED