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Wed Aug 26 10:55:40 BST 2009

I'm sure I misunderstand your message.  Fackler's "opinion" was expressed at
the conclusion of a thorough contemplation of evidence.  

Have you read the work?

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Blueflightmedic
Sent: Wednesday, August 26, 2009 3:34 AM
To: 'Trauma-List [TRAUMA.ORG]'
Subject: RE: Cx collar GSW neck

I remain fascinated by this desire to quote someone else's opinion seemingly
unbuttressed by any evidence as though such words mattered.

Scarily, I said as much on this very list 2 years ago, so clearly nobody
pays any attention to what I say. Which makes it beautifully rounded.

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bjorn, Pret
Sent: 24 August 2009 18:13
To: Trauma-List [TRAUMA.ORG]
Subject: RE: Cx collar GSW neck

I read Fackler, too:

"An intelligent surgeon, knowing nothing about gunshot wounds except
that they are contaminated, would most likely treat them quite
appropriately. He would base his treatment decisions on objective data
from the physical examination and x-ray studies, as he would in treating
any other form of trauma. The surgeon who has read and accepted what is
written in the wound ballistics literature could become a menace, doing
more harm with his treatment than was done by the bullet. It is
encouraging to note from the author's own experience as a combat surgeon
and contacts with others that most treatment of penetrating injuries
rendered on the field of battle was governed more by the common sense
and good training of the surgeon than by what is written in the wound
ballistics literature."

... not one word of which is to suggest that your particular experience
and interest has not made you a better surgeon.  But let's admit that
for the average nurse, medic, extender, physician or surgeon, ballistics
is a generally expendable area of expertise; and that in practical
application it tends to generate more confusion than clarity.

Pret

________________________________

	From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of McSwain, Norman E
Jr.
	Sent: Monday, August 24, 2009 12:47 PM
	To: Trauma-List [TRAUMA.ORG]
	Subject: RE: Cx collar GSW neck

	>40 years of operative management of GSW(Ok this is antidotal
but a lot of it. Our current penetrating trauma is at 65% of total
trauma. I have seen lots and lots of GSW's), Facklers reseaarch,
observation of research GSW's. multiple other written resources,
detailed assessment of the literature to write several book chapters on
the subject and several court trials both on mechanism of injury and
medical legal

	Otherwise not much

	Norman

	Norman McSwain MD
	Trauma Director, Charity Hospital
	Professor of Surgery, Tulane University
	New Orleans LA
	504 988 5111
	norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

	From: trauma-list-bounces at trauma.org on behalf of Bjorn, Pret
	Sent: Mon 8/24/2009 11:33 AM
	To: Trauma-List [TRAUMA.ORG]
	Subject: RE: Cx collar GSW neck

	Again, far be it for me to argue with Norm McSwain. 

	Nonetheless, I think this is an ill-defined and demonstrably
	unsubstantiated assertion.

	Is it based on any sort of data at all?

	Pret

	________________________________

	        From: trauma-list-bounces at trauma.org
	[mailto:trauma-list-bounces at trauma.org] On Behalf Of McSwain,
Norman E
	Jr.
	        Sent: Monday, August 24, 2009 12:20 PM
	        To: Trauma-List [TRAUMA.ORG]
	        Subject: RE: Cx collar GSW neck

	        you can't treat the wound completely, if you do not
understand
	the ballistics

	        Norman

	        Norman McSwain MD
	        Trauma Director, Charity Hospital
	        Professor of Surgery, Tulane University
	        New Orleans LA
	        504 988 5111
	        norman.mcswain at tulane.edu
<mailto:norman.mcswain at tulane.edu>

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Cx collar GSW neck