List Archives

Wed Apr 22 05:39:24 BST 2009

For the Code III really sick trauma patients, the time from the ED  
AMBULANCE DOCK to the operating room, we like to be between 45 seconds and 3  
minutes.    For such patients, the purpose of the EC is to wave  to the patient 
on their way from the ambulance to the OR.    For  others with obvious 
surgical problems, we like to keep the time between 5 and 10  minutes.     
"Resuscitation" in the EC merely adds time,  complications, and potential increase 
in death the longer the patient stays in  the EC and has fluids poured into 
them.   If they need chest tubes,  lines and intubation, all can be 
accomplished quicker in the OR.   For  trauma patients with minor injuries, the time 
in the EC is to work them up to  determine if they can go home, to the 
hospital floor, hospital clinic, hospital  ICU, or hospital OR.    If it is a 
hospital admission, then that  admission should occur the second that it is 
determined that the patient cannot  go home.    

k

In a message dated 4/21/2009 3:24:53 P.M. Central Standard Time,  
akulahawk at earthlink.net writes:

It's  been a couple years since I've done any transports in Sacramento, 
but from  what little I hear from current providers, UD Davis and Mercy 
San Juan  hospitals still function that way. Kaiser South Sacramento got 
approval to  start up a Trauma Center (Level II?) here as well. They're 
supposed to be  done with the hospital expansion and increased staffing 
this summer so  that they can begin functioning as a Level II Trauma 
Center. I have no  idea if they're going to do the same UCD thing for 
evaluating incoming  traumas.

Marc Matthews - MedPro MMC X wrote:
>  Dell,
>
> We can if we need to do so. We have the ability to run  straight to the 
OR and bypass the ED. It is the attending's call. Fortunately,  we are set up 
to do so. Where I am now, we are about 25 to 30 yards from the  OR once the 
patient hits the ED door.  However, most of the time it is  the 2 or 5 or 
10 minute drill just depending on the case. Where I trained at  UC Davis, we 
always stopped in the ED for an evaluation, plus the OR was on  the second 
floor. Mercy San Juan a few years ago was also based on the UC  Davis model. 
Same with several other midwestern trauma centers were I did my  more junior 
training. 
>
> All the best,
>
>
>  MRM
>
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> -----Original Message-----
> From:  trauma-list-bounces at trauma.org 
[mailto:trauma-list-bounces at trauma.org] On  Behalf Of moore677 at aol.com
> Sent: Monday, April 20, 2009 4:16  PM
> To: trauma-list at trauma.org
> Subject: Re: ED to OR  times
>
> During my fellowship and first job (East Texas), we did  direct OR 
transports when indicated.? Here in Phoenix (at least Joe's anyway),  we are not 
optimally set up to do that (we routinely don't know what we are  getting 
from Phoenix FD).? 
>
> Kumash, do you guys have direct OR  transport at either John C. Lincoln 
or Scottsdale?? 
>
> Dutch,  how about you guys at Maricopa?
>
>  Dell...............
>
>
> Forrest "Dell" Moore, MD,  FACS
> Trauma Critical Care Surgery
> Co-director, Trauma and  Surgical ICU
> St. Joseph's Hospital and Medical Center Phoenix,  AZ
>
>
>
>
>
>
>
>  -----Original Message-----
> From: McSwain, Norman E Jr.  <nmcswai at tulane.edu>
> To: Trauma and Critical Care mailing list  <trauma-list at trauma.org>
> Sent: Mon, 20 Apr 2009 1:47 pm
>  Subject: RE: ED to OR times
>
>
>
> For acute shocky  patients, we try to keep our times  to under 10 minutes
>
>  Norman
>  
> Norman McSwain MD
> Professor, Tulane  School of Medicine
> Trauma Director, Charity Hospital Trauma Center  norman.mcswain at tulane.edu
> 504 988 5111
>
> -----Original  Message-----
> From: trauma-list-bounces at trauma.org
>  [mailto:trauma-list-bounces at trauma.org] On Behalf Of Michelle Bailey
>  Sent: Monday, April 20, 2009 12:44 PM
> To:  trauma-list at trauma.org
> Subject: ED to OR times
>
> Curious  if anyone has an opinion or ideas backed by research about 
appropriate ED to  OR times for trauma patients.
> Thanks
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ED to OR times