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Sat Oct 18 20:08:09 BST 2008

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----- Original Message ----- 
From: "Brenildo Tavares" <brenildo33 at uol.com.br>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Saturday, October 18, 2008 5:04 PM
Subject: Re: Block that PUNT (and panel)


> As always Prof K Matox puts the finger at pain point.
> I mean his proposal to leave to industry the principles and rules instead 
> the Government lay talk as it is the way it happens in every country.
> Hope is the light and the strengh of life.
> It is necessary just to survive to see and enjoy the future.
> Brenildo Tavares  MD
> One Intensive care funders 1970 in Brasil
> For details please see in Google some of 4.000 references that happens to 
> be there
> looking either as Tavares, Brenildo or Brenildo Tavares
> If there are any doubts please honor me contacting as
> brenildo33 at uol.com.br as well as medmundi at uol.com.br
> BT
> President
> Continuing Medical Education International System
> and International Symposia.
> Both are no profit humanitarian communitary institutions founded in 1970 
> devoted toMedicine updating concepts and practice.
> ----- Original Message ----- 
> From: "Stephen Richey" <stephen.richey at gmail.com>
> To: "Trauma &amp, Critical Care mailing list" <trauma-list at trauma.org>
> Sent: Saturday, October 18, 2008 3:21 PM
> Subject: Re: Block that PUNT (and panel)
>
>
> No, you are not alone Dr. Matthews.  I could not have said what you did
> better myself.  As I have said beforehand, if I can contribute to
> organization or execution of such a meeting, I am willing to put myself 
> and
> my abilities at the beckon call of those with seniority to me.
>
>
>
> On Sat, Oct 18, 2008 at 1:00 PM, Marc Matthews - MedPro MMC X <
> Marc_Matthews at medprodoctors.com> wrote:
>
>> Sir,
>>
>> I am not alone in saying that we look up to you. When we attend your
>> tremendous meeting in Las Vegas, we listen to you and the many 
>> influential
>> leaders that you have assembled for advice on the challenges in the 
>> current
>> trauma world. We also look to all of your and those leader's papers in 
>> the
>> literature to refine, re-define and fine-tune the critical care issues 
>> and
>> acute surgical techniques with which we then use to treat our sickest
>> patients.
>>
>> My thoughts were with the raising death toll in this pre-hospital,
>> aero-medical transport field, the concern over the appropriate launch
>> criteria (clinical versus mechanism versus non-trauma), and the risk that
>> many crews are asked to take with or without the proper aeronautical
>> instruments that should be considered standard by today's technology.
>> Perhaps a national meeting could be arranged to review and make
>> recommendations as to the aforementioned. Perhaps that meeting even 
>> mandates
>> change in many areas in such a mode of transport, where it would be
>> considered unethical or "poor care" for patients to be flown and 
>> physicians
>> or medical directors would be no longer able to do so without following 
>> much
>> more formal guidelines.
>>
>> Who knows the literature best? Or more appropriately, who could take all 
>> of
>> the literature and assemble the greatest minds that know this field and 
>> come
>> out with a declaration of what is known, what is advised and what is not
>> advised for this field? With personal bias exposed and evidence based
>> research placed at the forefront, such a position could in fact be used 
>> to
>> influence change. Perhaps even national research projects could be 
>> generated
>> that could involve trauma and non-trauma centers to answer questions on 
>> such
>> a massive scale that the results could no longer be refuted. Safety would 
>> be
>> the goal for patients and crew. The FAA and NTSB could be invited to 
>> watch
>> the process or participate.
>>
>> If panels at this meeting have a consensus or if research projects are
>> developed, implemented, and later completed, they could learn of what
>> changes needed to be implemented. That body of information could then be
>> taken to the congressional or state legislative bodies to demonstrate 
>> what
>> was found and what the medical literature supports and create change form
>> the data as it would save lives and money. It may take time, effort and
>> money, but a course should be plotted for completion of projects and 
>> perhaps
>> a follow-up meetings to finish the details.
>>
>> Such action will save lives. It could save insurance companies big money,
>> so that they are not paying for helicopter flights from a local crash 
>> scene
>> to a hospital that is 10 minutes driving time because someone felt that 
>> it
>> would be easier or better or safer or however they were feeling at that
>> moment. I had a case just last night where a 9 percent burn was flown 
>> from
>> one institution to mine. The patient was "stable" without airway 
>> compromise
>> and normal vital signs, but the other institution had a protocol that 
>> said
>> that "all burns must be flown"! We asked them several times not to fly 
>> the
>> patient and we were refused. Now, the family will now have to pay (eat) 
>> over
>> $20,000 dollars for that flight instead of $500 for ground 
>> transportation.
>> The patient will be discharged 36 hours after arrival. The risk to the 
>> crew
>> and the waste of resources including fuel and the potential need for that
>> helicopter somewhere else in their county having now been lost is just
>> unforgivable and happens many times, but I am sure we all have our war
>> stories.
>>
>> The bottom line for me was reading for several weeks the urgency in the
>> e-mails and at times the vitriol from www.trauma.org. In your last Las
>> Vegas meeting you praised this website in bringing the world-wide trauma
>> community to together. The audience agreed and applauded. Well, here we 
>> sit
>> reading for weeks about this problem. So, I was thinking, if there is one
>> person that has the ability to bring together this community in person,
>> including the greatest minds in trauma, critical care and acute surgery, 
>> it
>> is Dr. Kenneth Mattox. It is not presumptuous to ask a great man for 
>> help.
>> He knows how to organize and direct such a meeting (we read your e-mails
>> about your helping the Katrina and Rita evacuees at the Superdome and 
>> have
>> seen the organization at your Las Vegas meetings), how to do the 
>> research,
>> who knows who the participants SHOULD be so that this will not a "white
>> washing" as suugested in a recent e-mail, and how to effect change. Dr.
>> Kenneth Mattox could bring together these forces in just more than an
>> afternoon session but at a larger meeting, perhaps even a closed meeting 
>> at
>> first to organize, where ideas could be flushed out and a clearer
>> understanding of what needs to have happen could be decided, and then 
>> action
>> taken in whatever form it must, such as a national research project, a
>> position paper, incorporation of other bodies such as the ACS COT, NFTC,
>> EAST, etc, into this effort. The "industry" must have medical evidence 
>> based
>> knowledge and input rather than pecuniary concerns or misguided 
>> approaches
>> that would not meet such evidence based criteria. It has the greatest 
>> chance
>> of the fox watching the henhouse. There must be input into those industry
>> "Standards". We here in Arizona have had three devastating incidents just
>> this year, one of which involved one of my trauma nurse's family members.
>>
>> It is a tall order, Dr. Mattox, to ask this of you, and I do appreciate
>> this. However, if there is one man that could do this, organize this, 
>> meet
>> this challenge, I doubt that few on this website would disagree, that it 
>> is
>> you. Now, I apologize for placing you in this "hotseat" or confronting 
>> you
>> in front of this site, calling you to action, but perhaps we, the trauma 
>> and
>> medical community, need you as a leader that is recognized, to help us
>> confront what needs to be confronted or change what needs to be changed. 
>> As
>> for the details on how to do this, when, where, who, those details are 
>> for
>> much greater minds than mine, but I do believe that the people are crying
>> out for change. I think we know who that person is and the only question 
>> is
>> when . . . I will now sit down and be quiet as I feel I have said perhaps
>> far too much. I apologize if I have offended anyone, including Dr. Mattox 
>> or
>> the body of this tremendous website. Perhaps it is my juvenile angst, 
>> hubris
>> or immaturity, or all of the above, but it pains me to see this happening
>> and I feel powerless to do anything.
>>
>> Very respectfully,
>>
>> Marc Matthews, MD
>>
>>
>> CONFIDENTIALITY NOTICE: This message and any of the attached documents
>> contain information from the Medical Professional Associates of Arizona,
>> (MedPro), that may be confidential and/or privileged. If you are not the
>> intended recipient, you may not read, copy, distribute, or use this
>> information, and no privilege has been waived by your inadvertent 
>> receipt.
>> If you received this transmission in error, please notify the sender by
>> reply email and then delete this message. Thank you.
>>
>> CONFIDENTIAL MATERIALS PROTECTED under ARS § 36-445, ARS § 36-2403 and
>> Federal Patient Safety and Quality Improvement Act of 2005
>>
>>
>> -----Original Message-----
>> From: trauma-list-bounces at trauma.org [mailto:
>> trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
>> Sent: Friday, October 17, 2008 7:47 PM
>> To: trauma-list at trauma.org
>> Cc: Redstart at aol.com; KMATTOX at aol.com
>> Subject: Re: Block that PUNT (and panel)
>>
>> Dr. Matthews:   I am intrigued by your  suggestion.     My role at the
>> meeting you cited is to be a  catalyst to bring together in one venue the
>> persons
>> and subjects you  cited.     It is too late for this year to have a 
>> special
>> day, but I might have a "blue sky" noon session on Tuesday if there is
>>  interest.
>>      I would never be so presumptuous  as to even know all of the agenda
>> items or just who all the stakeholders  are.    I do know that today 
>> State
>> Senators from Maryland  began  calling for witnesses to testify to them
>> about this
>> issue.   I do know that it is better if industry creates the STANDARDS 
>> and
>> Principles, rather than government creating the  regulations.
>>
>> k mattox
>>
>>
>> In a message dated 10/12/2008 11:01:15 A.M. Central Daylight Time,
>> Marc_Matthews at medprodoctors.com writes:
>>
>> Okay,  Trauma.org, then everyone on this list server should form a 
>> meeting.
>> All of  you can get together and discuss it with every single paper ever
>> written. You  can even invite people that are from the government and 
>> those
>> from outside the  United States and you can bring these great minds 
>> together
>> and wrangle it out.  Imagine the best and the brightest all coming 
>> together.
>> Imagine deciding the  reasons for transport and saving lives from 
>> needless
>> death yet defining the  reasons for the use of such transport and then
>> tracking your changes. It can  and should be done instead of complaining
>> about others meeting that will  either white wash this or do it wrong!
>>
>> Dr. Mattox, every year you bring  together many to a meeting in Las Vegas
>> to educate. I been there three times.  I have Dr. Wisner, Knudsen, Rhee, 
>> the
>> Dorlacs, Johanigman, Sise, McSwain,  Fildes, Tuggle, and many others, 
>> true
>> heroes that discuss the latest on  trauma, acute care surgery and 
>> critical
>> care. You have even expanded your  meeting to include a Disaster
>> Preparedness ssection.
>> Why not a day, two or  three somewhere to resolve this issue? Of anyone
>> that can organize such a  meeting and decide such issues that has the 
>> power
>> to org anize, it is you. It  is a large enough issue for people to have
>> disscussed this for weeks now. If  somewhere "they" are doing it "wrong",
>> then do it right.
>> Have that meeting and  then bring it out in the literature and take it up
>> the stairs to Washington.  Get the ACS COT or NFTC behind you and get the 
>> US
>> trauma world to go to their  representatives and change it.
>>
>> This website could be the used as a  launch pad to help save lives in an
>> organized fashion but someone needs to  lead. Now who is it going to be? 
>> I
>> nominate Dr. Mattox and then everyone on  this web server to help who has
>> been so bold as to write in and speak up. The  squeaky wheel gets the
>> grease! Either that or we sit here and do nothing. We  need a leader. Who
>> will that be . . . ?
>>
>> MRM
>>
>> ________________________________
>>
>> From:  trauma-list-bounces at trauma.org on behalf of KMATTOX at aol.com
>> Sent: Sat  10/11/2008 7:24 PM
>> To: trauma-list at trauma.org
>> Subject: Block that PUNT  (and panel)
>>
>>
>>
>> My wife is from Oklahoma.    I and many  of my friends are  from Texas. I
>> thoroughly enjoyed  watching the Oklahoma/Texas game  today.     I really
>> did
>>  not
>> have a dog in the  hunt.    But the game with its swings  back and forth
>> was a
>> GREAT  game.    I heard the stands  yell, "BLOCK THAT PUNT" even   when 
>> the
>> team came to the line to  try for two points and NOT  PUNT.
>>
>> It is with GREAT  sadness and frustration, that I have learned and inform
>> anyone who wishes  to know, tremendous, TREMENDOUS forces have formed to
>> BLOCK that Panel  which is being proposed to be formed to look at safety
>> standards , flight criteria,  weather conditions,  charges, and  quality
>>  review by the
>> regions trauma system.     It is  really SAD  that forces in industry, in
>> hospitals, and some  individuals have put  considerable pressure on local
>> agencies, state  agencies, federal agencies, and  even individuals to 
>> state
>> that a "panel"
>> is not needed, that the indirect data  is sufficient, and that  deaths 
>> have
>> occurred in ground ambulance  crashes.       A huge diversionary tactic 
>> is
>> being
>> orchestrated with as great a focus as  either the democratic or 
>> republican
>> presidential and congressional  campaign of 2008.
>>
>> If this campaign to BLOCK the PANEL is  successful or even achieves a
>> DELAY, then the next deaths from a  preventable helicopter crash, 
>> carrying a
>> patient that did not need such a  transport or even a higher level of 
>> care,
>> must be
>> attributable to societal  lethargy and business strong armed  tactics.
>>
>> k
>>
>>
>> In a message dated 10/11/2008 3:17:51 P.M. Central  Daylight Time,
>> bbledsoe at earthlink.net writes:
>>
>> Perhaps
>> "the  panel" will be that  introspection.
>>
>> Bryan
>>
>> Bryan Bledsoe,  DO,  FACEP
>>
>>
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>>
>
>
>
> -- 
> 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
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>
>
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