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Thu Apr 23 16:19:00 BST 2009

My simple answer - out of the ED and to the ICU or OR as soon as is humanly possible.  I routinely shoot for < 30 minutes, but I am thrilled if it is under 60.......

Ron

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Michelle Bailey
Sent: Thursday, April 23, 2009 11:02 AM
To: Trauma and Critical Care mailing list
Subject: Re: ED to OR times

Thank you all for your comments -
Another question: What are folks ideas on ED dwell time? and thoughts about
ED to ICU times. Our goal is less than 2 hours for both ED dwell time and
time to ICU but our average right now is 4 hours. Thoughts? also thoughts on
shortening the time to get to ICU.

Thanks

On Tue, Apr 21, 2009 at 10:39 PM, <KMATTOX at aol.com> wrote:

> 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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