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Wed Oct 1 19:27:48 BST 2008

Perfect evaluation.
 May I cite your ideas when preparing some teaching material?
Best personal compliments for clearcut statements
Who I Am ?
Pleas go to ww.Google etc and ask for Brenildo Tavares.
There are about 484 citations.
Or look at www.cuil etc and ask Tavares, Brenildo.
You will find libraries of Texas and Tenessee universities inicating some of 
my books published together with William Shoemaker.

Brenildo Tavares  MD
President
1- Continuing Medical Education International System
2- Intwrnational Symposia on Acute Care
Non profit humanitarian Institution

founded in 1970 at Rio de Janeiro  RJ  Brasil

----- Original Message ----- 
From: "McSwain, Norman E Jr." <nmcswai at tulane.edu>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Tuesday, September 30, 2008 6:52 PM
Subject: RE: trauma-list Digest, Vol 63, Issue 39

> The problem is lack of consistent triage criteria for helicopter
> transportation and the lack of consideration of ground transport to
> closer hospital for minor injuries. (or for mechanism of injury as an
> indication). For example all of us know that using mechanism alone
> produces an over-triage of >60%. Consideration for movement of this
> indication to a closer hospital and then inter hospital transport to
> the trauma center should be done.
>
> That does not say helicopters are bad. Certainly they are good when
> indicated. A comparison perhaps is the every GSW of the chest does not
> need a thoracotomy. A major portion can be treated with a chest tube.
> Likewise every trauma patient does not need helicopter transport to the
> trauma center. Many can go be ground to a closer facility for assessment
> and then to the trauma by the best vehicle as conditions dictate
>
> Back to principles and preferences. The principle is good trauma care.
> The preference is where, when and how based on conditions of the patient
> and the situation of distance, time and weather
>
> 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 Forrest Robleto
> Sent: Tuesday, September 30, 2008 4:34 PM
> To: Trauma &amp, Critical Care mailing list
> Subject: Re: trauma-list Digest, Vol 63, Issue 39
>
> I just worry that the arguments are not objective.  I know that there
> are
> places in New Jersey that are as much as two hours from a trauma center
> in
> heavy traffic.  (20 minutes otherwise).  I believe there are too many
> helicopter flights but I do not believe that all of them are
> unnecessary.
>
> You seem to be  against helicopters and your arguments may be right in
> some
> places at some times.
>
> I wouldn't want to second guess folks who were actually looking at the
> weather when they made the decision to fly.
>
> I know I saw different weather than the forecast you heard and much more
> traffic than the norm for Saturday evening.
>
> On Tue, Sep 30, 2008 at 7:46 AM, Stephen Richey
> <stephen.richey at gmail.com>wrote:
>
>> Yes, but the traffic significantly decreases (most of the time) once
> you
>> get
>> out away from 95 and 495 especially during non-peak hours.  The main
> route
>> from the Waldorf area to the hospital they were headed to originally
> is
>> not nearly as busy as the interstate, save for rush hour and on
> holiday
>> weekends.
>>
>> >From the weather reports I heard, the rain was described as "light to
>> moderate" so that is what I based my comments upon.  However, I agree
> with
>> the assessment that the weather was far below what I would have flown
> into,
>> even with every imaginable electronic safety system known to man at my
>> disposal.  Despite considering the pilot in question to be one of the
> best
>> I
>> ever had the pleasure of flying with (and I've flown with a lot of
>> helicopter pilots so that is saying something), I still question his
>> judgment in accepting the mission given the weather conditions.  The
>> "corporate culture" of aeromedical operations in general and
> especially the
>> MSP aviation division would be likely contributing factors in the
> flawed
>> decision making that cost a good pilot and his passengers their lives.
>>
>>
>> On Tue, Sep 30, 2008 at 7:00 AM, <trauma-list-request at trauma.org>
> wrote:
>>
>> > I was on the road ( I-95, I-695) that night, traffic was very heavy
>> > and the rain (remnants of a passing hurricane) was also very heavy.
> I
>> >  don't know about the necessity of that particular flight but the
>> > traffic and the weather were not good.  I was driving from NJ to
>> > Baltimore.
>>
>>
>> --
>> Stephen L. Richey, CRT
>> Aviation Injury Research Project Leader
>> Saginaw Valley State University
>> Work E-mail: slrichey at svsu.edu
>> Home Office Phone: 248-366-4452
>>
>> "It is the characteristic excellence of the strong man that he can
> bring
>> momentous issues to the fore and make a decision about them. The weak
> are
>> always forced to decide between alternatives they have not chosen
>> themselves."- Dietrich Bonhoeffer
>> --
>> trauma-list : TRAUMA.ORG <http://trauma.org/>
>> To change your settings or unsubscribe visit:
>> http://www.trauma.org/index.php?/community/
>>
>
>
>
> -- 
> V/R
>
> Forrest Robleto
> R House Health & Safety
> www.RHouseTraining.com
> FRobleto at RhouseTraining.com
> 609-792-9047
>
> "In a completely rational society, the best of us would be teachers and
> the
> rest of us would have to settle for something less."
> --Lee Iacocca
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG
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