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Mon Jul 28 14:12:58 BST 2008

No definite answers here, either, but I would like to point out that the US healthcare system also appears to be very expensive compared to others that offer similar average levels of care. Perhaps the US could learn something from other countries that are more successful at providing good care at a reasonable cost, both to the individual patient and to society as a whole?
John Annen
Zurich, Switzerland

----- Original Message ----
From: Charlene M Morris <cvmmorris at gmail.com>
To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Sent: Monday, July 28, 2008 2:41:39 PM
Subject: Re: trauma-list Digest, Vol 61, Issue 44

I am not sure. You may still go to www.slate.com for the article.

Honestly, I do not have the answer to the ER dilemma-- but our system in the
US is a catch-all-- over extended, stressed and despite dedicated people and
theoretically, incredible resources, it is often a matter of surviving the
shift.

Solutions? I do not have them.

C M Morris, PA-C

On 7/28/08, dapo osinowo <dapoosinowo20002000 at yahoo.com> wrote:
>
>
>
> --- On Sun, 7/27/08, trauma-list-request at trauma.org <
> trauma-list-request at trauma.org> wrote:
>
> From: trauma-list-request at trauma.org <trauma-list-request at trauma.org>
> Subject: trauma-list Digest, Vol 61, Issue 44
> To: trauma-list at trauma.org
> Date: Sunday, July 27, 2008, 4:00 AM
>
> Send trauma-list mailing list submissions to
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> Today's Topics:
>
>  1. Of interest-- how hospital ERs kill patients (Charlene M Morris)
>
>  3. RE: Of interest-- how hospital ERs kill patients
>      (McSwain, Norman E Jr.)
>  5. Re: Of interest-- how hospital ERs kill patients (sjasmd at aol.com)
>  6. Retrohepatic venous injuries (Ranjith Ellawala)
>  7. RE: Of interest-- how hospital ERs kill patients (John Holmes)
>  8. Re: Of interest-- how hospital ERs kill patients (sjasmd at aol.com)
>  9. Re: Of interest-- how hospital ERs kill patients (julie miller)
> 10. Re: Retrohepatic venous injuries (nappio at aol.com)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Sat, 26 Jul 2008 09:40:27 -0400
> From: "Charlene M Morris" <cvmmorris at gmail.com>
> Subject: Of interest-- how hospital ERs kill patients
> To: "Trauma &amp, Critical Care mailing list"
> <trauma-list at trauma.org>
> Message-ID:
>        <ca095570807260640j3ae8715bm5ab6ac32105b749f at mail.gmail.com>
> Content-Type: text/plain; charset=ISO-8859-1
>
> http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> Amazing-- from a news source I typically read and appreciate.
>
> C M Morris
>
>
> ------------------------------
>
> Message: 2
> Date: Sat, 26 Jul 2008 11:31:26 -0400
> From: "Errington Thompson " <errington at erringtonthompson.com>
> Subject: RE: Knee dislocation: anyone still doing angiography in
>        patients        with    symmetrical pulses?
> To: "'Trauma & Critical Care mailing list'"
>        <trauma-list at trauma.org>
> Message-ID: <009b01c8ef34$aba67590$02f360b0$@com>
> Content-Type: text/plain;      charset="us-ascii"
>
> I know that I'm walking into a trap but no I don't.  I wrote up a small
> series of patients with knee dislocations.  Everyone with abnormal pulses
> (except) one had an injury.  Everyone with normal pulses got an arteriogram
> and had a normal a-gram.
>
> E
>
> Errington C. Thompson, MD
> Trauma/Surgical Critical Care
> Talk Show Host - WPEK
> www.whereistheoutrage.net
> Asheville, NC
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of sjasmd at aol.com
> Sent: Saturday, July 26, 2008 1:01 AM
> To: trauma-list at trauma.org
> Subject: Knee dislocation: anyone still doing angiography in patients with
> symmetrical pulses?
>
>
>
>
>
>
> View full size
>
>
>
>
> 56 yo obese female (120 kg 1.67 M) slipped on water outside her home and
> dislocated her left knee. Reduction was accomplished. Pulses were
> symmetrical. Strong dorsalis pedis pulses?bilaterally, imperceptible
> posterior tibial pulses. Mild pain in knee.
>
> Does anyone still perform angiography for this scenario.
>
>
> sal sclafani
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
> ------------------------------
>
> Message: 3
> Date: Sat, 26 Jul 2008 10:51:36 -0500
> From: "McSwain, Norman E Jr." <nmcswai at tulane.edu>
> Subject: RE: Of interest-- how hospital ERs kill patients
> To: "Trauma & Critical Care mailing list"
> <trauma-list at trauma.org>
> Message-ID:
>        <B79C02DCC4FA074DB02381DF1C5D60BA017ADD7F at EX07.ad.tulane.edu>
> Content-Type: text/plain;      charset="us-ascii"
>
> "ER's kill patients" and websites don't work is there a
> relationship?
>
> Your search for "letters.slate.com%2FW0RH01847F83B6945D6E..."
> returned
> no results.
>
> Norman
>
> Norman McSwain Jr, MD FACS
> Trauma Director Charity Hospital
> Professor of Surgery
> Tulane University School of Medicine
> 504 988 5111
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Charlene M Morris
> Sent: Saturday, July 26, 2008 8:40 AM
> To: Trauma &amp, Critical Care mailing list
> Subject: Of interest-- how hospital ERs kill patients
>
> http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> Amazing-- from a news source I typically read and appreciate.
>
> C M Morris
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
> ------------------------------
>
> Message: 4
> Date: Sat, 26 Jul 2008 12:01:34 -0400
> From: sjasmd at aol.com
> Subject: Re: Knee dislocation: anyone still doing angiography in
>        patients with  symmetrical pulses?
> To: trauma-list at trauma.org
> Message-ID: <8CABD5002C007C7-1530-13D2 at webmail-me15.sysops.aol.com>
> Content-Type: text/plain; charset="us-ascii"
>
> E
>
> i am not trapping you but both of us would have been trapped in this case.
> I
> will give more followup after some more time for others to weigh in on this
> controversy
>
>
> sal
>
>
> -----Original Message-----
> From: Errington Thompson <errington at erringtonthompson.com>
> To: 'Trauma & Critical Care mailing list'
> <trauma-list at trauma.org>
> Sent: Sat, 26 Jul 2008 11:31 am
> Subject: RE: Knee dislocation: anyone still doing angiography in patients
> with
> symmetrical pulses?
>
>
>
> I know that I'm walking into a trap but no I don't.  I wrote up a small
> series of patients with knee dislocations.  Everyone with abnormal pulses
> (except) one had an injury.  Everyone with normal pulses got an arteriogram
> and had a normal a-gram.
>
> E
>
> Errington C. Thompson, MD
> Trauma/Surgical Critical Care
> Talk Show Host - WPEK
> www.whereistheoutrage.net
> Asheville, NC
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of sjasmd at aol.com
> Sent: Saturday, July 26, 2008 1:01 AM
> To: trauma-list at trauma.org
> Subject: Knee dislocation: anyone still doing angiography in patients with
> symmetrical pulses?
>
>
>
>
>
>
> View full size
>
>
>
>
> 56 yo obese female (120 kg 1.67 M) slipped on water outside her home and
> dislocated her left knee. Reduction was accomplished. Pulses were
> symmetrical. Strong dorsalis pedis pulses?bilaterally, imperceptible
> posterior tibial pulses. Mild pain in knee.
>
> Does anyone still perform angiography for this scenario.
>
>
> sal sclafani
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
> ------------------------------
>
> Message: 5
> Date: Sat, 26 Jul 2008 12:06:58 -0400
> From: sjasmd at aol.com
> Subject: Re: Of interest-- how hospital ERs kill patients
> To: trauma-list at trauma.org
> Message-ID: <8CABD50C44AC1F7-1530-140C at webmail-me15.sysops.aol.com>
> Content-Type: text/plain; charset="us-ascii"
>
> i wish i could comment on this one but alas too close to home
>
> but slade probably has it wrong on the pe
>
>
> sal
>
>
> -----Original Message-----
> From: Charlene M Morris <cvmmorris at gmail.com>
> To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
> Sent: Sat, 26 Jul 2008 9:40 am
> Subject: Of interest-- how hospital ERs kill patients
>
>
>
> http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> Amazing-- from a news source I typically read and appreciate.
>
> C M Morris
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
> ------------------------------
>
> Message: 6
> Date: Sat, 26 Jul 2008 19:01:24 +0100 (BST)
> From: Ranjith Ellawala <ranjithellawala at yahoo.com>
> Subject: Retrohepatic venous injuries
> To: Trauma &amp Critical Care mailing list <trauma-list at trauma.org>
> Message-ID: <125844.60362.qm at web55008.mail.re4.yahoo.com>
> Content-Type: text/plain; charset=iso-8859-1
>
> Dear all,
> I am aware that some of you have lot of experience and success with these
> injuries.
> How do you all handle these?
> I value your input; Please indicate your success rate as well.
> Thank you
> Ranjith Ellawala
> Trauma Unit,
> The National Hospital of Sri Lanka,
> Colombo
>
> Send instant messages to your online friends http://uk.messenger.yahoo.com
>
> ------------------------------
>
> Message: 7
> Date: Sun, 27 Jul 2008 05:51:09 +1000
> From: John Holmes <docjohnholmes at hotmail.com>
> Subject: RE: Of interest-- how hospital ERs kill patients
> To: "Trauma & Critical Care mailing list"
> <trauma-list at trauma.org>
> Message-ID: <BLU131-W10A5752D182F25089D26B3B4810 at phx.gbl>
> Content-Type: text/plain; charset="iso-8859-1"
>
> Geez - ED's kill people .......... Intensivists have poorer outcomes
>
> Perhaps we'd all better quit now.
>
> J.
>
>
>
> Dr John L Holmes
> Emeritius Director Emergency Medicine Training
> AMC & OLVG, Amsterdam
> The Netherlands
>
> > To: trauma-list at trauma.org
> > Subject: Re: Of interest-- how hospital ERs kill patients
> > Date: Sat, 26 Jul 2008 12:06:58 -0400
> > From: sjasmd at aol.com
> >
> > i wish i could comment on this one but alas too close to home
> >
> > but slade probably has it wrong on the pe
> >
> >
> > sal
> >
> >
> > -----Original Message-----
> > From: Charlene M Morris <cvmmorris at gmail.com>
> > To: Trauma &amp, Critical Care mailing list
> <trauma-list at trauma.org>
> > Sent: Sat, 26 Jul 2008 9:40 am
> > Subject: Of interest-- how hospital ERs kill patients
> >
> >
> >
> > http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> > Amazing-- from a news source I typically read and appreciate.
> >
> > C M Morris
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
>
>
> ------------------------------
>
> Message: 8
> Date: Sat, 26 Jul 2008 16:02:50 -0400
> From: sjasmd at aol.com
> Subject: Re: Of interest-- how hospital ERs kill patients
> To: trauma-list at trauma.org
> Message-ID: <8CABD71B7836417-1530-1E84 at webmail-me15.sysops.aol.com>
> Content-Type: text/plain; charset="us-ascii"
>
> look at the video to understand the outrage
>
>
>
>
>
> -----Original Message-----
> From: John Holmes <docjohnholmes at hotmail.com>
> To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
> Sent: Sat, 26 Jul 2008 3:51 pm
> Subject: RE: Of interest-- how hospital ERs kill patients
>
>
>
> Geez - ED's kill people .......... Intensivists have poorer outcomes
>
> Perhaps we'd all better quit now.
>
> J.
>
>
>
> Dr John L Holmes
> Emeritius Director Emergency Medicine Training
> AMC & OLVG, Amsterdam
> The Netherlands
>
> > To: trauma-list at trauma.org
> > Subject: Re: Of interest-- how hospital ERs kill patients
> > Date: Sat, 26 Jul 2008 12:06:58 -0400
> > From: sjasmd at aol.com
> >
> > i wish i could comment on this one but alas too close to home
> >
> > but slade probably has it wrong on the pe
> >
> >
> > sal
> >
> >
> > -----Original Message-----
> > From: Charlene M Morris <cvmmorris at gmail.com>
> > To: Trauma &amp, Critical Care mailing list
> <trauma-list at trauma.org>
> > Sent: Sat, 26 Jul 2008 9:40 am
> > Subject: Of interest-- how hospital ERs kill patients
> >
> >
> >
> > http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> > Amazing-- from a news source I typically read and appreciate.
> >
> > C M Morris
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
> ------------------------------
>
> Message: 9
> Date: Sat, 26 Jul 2008 14:28:56 -0700 (PDT)
> From: julie miller <jamiller444 at yahoo.com>
> Subject: Re: Of interest-- how hospital ERs kill patients
> To: "Trauma & Critical Care mailing list"
> <trauma-list at trauma.org>
> Message-ID: <16474.53015.qm at web56908.mail.re3.yahoo.com>
> Content-Type: text/plain; charset=iso-8859-1
>
> in Victoria, Australia, where the hospitals are the responsibility of the
> state
> government, ER wait times are measured and reported, and there is great
> effort
> to get patients out as quickly as possible. the hospital receives its
> government funding based partly on kpi's, including % of patients in ED
> over 4 and 8 hours.
> it has mostly been good, and we have received more money to better staff
> the
> ER.?the down side?is the occasional inappropriate admission of an ER
> patient to
> a bed before being evaluated by the admitting team, though, which really
> annoys
> us.
> Julie Miller
>
>
>
> ----- Original Message ----
> From: "sjasmd at aol.com" <sjasmd at aol.com>
> To: trauma-list at trauma.org
> Sent: Sunday, July 27, 2008 6:02:50 AM
> Subject: Re: Of interest-- how hospital ERs kill patients
>
> look at the video to understand the outrage
>
>
>
>
>
> -----Original Message-----
> From: John Holmes <docjohnholmes at hotmail.com>
> To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
> Sent: Sat, 26 Jul 2008 3:51 pm
> Subject: RE: Of interest-- how hospital ERs kill patients
>
>
>
> Geez - ED's kill people .......... Intensivists have poorer outcomes
>
> Perhaps we'd all better quit now.?
>
> J.
>
>
>
> Dr John L Holmes
> Emeritius Director Emergency Medicine Training
> AMC & OLVG, Amsterdam
> The Netherlands
>
> > To: trauma-list at trauma.org
> > Subject: Re: Of interest-- how hospital ERs kill patients
> > Date: Sat, 26 Jul 2008 12:06:58 -0400
> > From: sjasmd at aol.com
> >
> > i wish i could comment on this one but alas too close to home
> >
> > but slade probably has it wrong on the pe
> >
> >
> > sal
> >
> >
> > -----Original Message-----
> > From: Charlene M Morris <cvmmorris at gmail.com>
> > To: Trauma &amp, Critical Care mailing list
> <trauma-list at trauma.org>
> > Sent: Sat, 26 Jul 2008 9:40 am
> > Subject: Of interest-- how hospital ERs kill patients
> >
> >
> >
> > http://letters.slate.com/W0RH01847F83B6945D6E72B296ABA0
> > Amazing-- from a news source I typically read and appreciate.
> >
> > C M Morris
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
> ------------------------------
>
> Message: 10
> Date: Sat, 26 Jul 2008 23:31:48 +0000
> From: nappio at aol.com
> Subject: Re: Retrohepatic venous injuries
> To: "Trauma & Critical Care mailing list"
> <trauma-list at trauma.org>
> Message-ID:
>
> <1356264151-1217115099-cardhu_decombobulator_blackberry.rim.net-1258226119- at bxe198.bisx.prod.on.blackberry
> >
>
> Content-Type: text/plain
>
> We had a retrohepatic ivc injury with large pseudoaneurysm but
> hemodynamically
> stable,  we watched him and he survived...check it out in the trauma.org
> archives 1997.
> ------Original Message------
> From: Ranjith Ellawala
> Sender: trauma-list-bounces at trauma.org
> To: Trauma &amp Critical Care mailing list
> ReplyTo: Trauma & Critical Care mailing list
> Sent: Jul 26, 2008 14:01
> Subject: Retrohepatic venous injuries
>
> Dear all,
> I am aware that some of you have lot of experience and success with these
> injuries.
> How do you all handle these?
> I value your input; Please indicate your success rate as well.
> Thank you
> Ranjith Ellawala
> Trauma Unit,
> The National Hospital of Sri Lanka,
> Colombo
>
> Send instant messages to your online friends http://uk.messenger.yahoo.com
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
> Sent from my Verizon Wireless BlackBerry
>
>
> ------------------------------
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
> End of trauma-list Digest, Vol 61, Issue 44
> *******************************************
>
>
>
> --
> trauma-list : TRAUMA.ORG
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> http://www.trauma.org/index.php?/community/
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