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Where are the SURGEONS?

Robert Smith rfsmithmd at comcast.net
Sun Mar 22 14:26:55 GMT 2009

I'm stunned in one sense, but perhaps not totally surprised I guess,  
to read that surgeons are being systematically excluded from planning  
of EMS and disaster management. It's also sad that you would even feel  
a need to defend the surgeon's current and historic role. I would have  
liked to think that everyone was aware of those by now.

Why do you think this has come about?

On Mar 22, 2009, at 9:30 AM, McSwain, Norman E Jr. wrote:

> This is the old story of when the elevator door closes with the  
> patient  headed to the OR from the ED, that the emergency is over.  
> No one thinks of the continued care that the patient needs and the  
> importance of how the planning of the initial care impacts the later  
> care. Ken is correct. of late there has been a "purposeful EXCLUSION  
> of surgeons in many  areas" from the planning of EMS, disaster  
> management both outside the hospital and in the hospital.
> This is interesting because surgeons have been actively involved in  
> the starting of all emergency care and EMS. Starting from Larrey  
> with Napoleon in 1699, to Farrington starting EMS in the US in the  
> 1950's, the start of ATLS in the late 1970's, the start of PHTLS in  
> the early 1980's and yes  even emergency medicine was started by  
> surgeons in the US.
> 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 KMATTOX at aol.com
> Sent: Sun 3/22/2009 8:02 AM
> To: trauma-list at trauma.org
> Subject: Where are the SURGEONS?
> Pret:   My question about "where are the surgeons" related to the   
> discussion
> as it entered into the regional trauma system and  EMS/EM system   
> development
> (in general).   The post at that point talked about  emergency  
> medicine and
> EMS, but nothing about surgical involvement in a  regional, area  
> wide, or even
> city trauma system.   It was surgeons,  working with all others in  
> health care
> (EMS, nursing, EM, administrators,  politicians, and yes, YOU, with  
> your many
> hats) that developed and grew the  Trauma System in Maine.     I can  
> tell you
> from first  experience in talking to people around the world, and  
> including
> medical disaster  planning and response, there is a purposeful  
> surgeons in many  areas, thinking trauma care is in the arena of  
> emergency
> medicine and ems  only.    We are all in this together.
> k
> In a message dated 3/22/2009 7:48:05 A.M. Central Daylight Time,
> p.bjorn at netzero.net writes:
> So.  Four hours later, as her brainstem squeezes out the bottom of   
> her
> skull... WHERE are the SURGEONS?
> Forgive me when I  suggest that this is at least an unnecessarily  
> obtuse, if
> not altogether  silly, question.  There is zero assurance that her  
> outcome
> would be  any better had she been injured in any resort in Montana,  
> Utah,
> Colorado,  or Maine.  Speaking only for Maine, I'm confident that  
> she would
> have  been at a trauma center in well under an hour (probably half  
> of that)
> from  the time of the second EMS call
> **************Feeling the pinch at the grocery store?  Make dinner  
> for $10 or
> less. (http://food.aol.com/frugal-feasts?ncid=emlcntusfood00000001)
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