Where are the SURGEONS?

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We had one surgeon who in one operation went into 3 body cavities.  
Abdomen, chest, and then brain when asked to and when he saw pupils  
dilating. Patient then went to neurosurgeon for further care. Survived  
( sort of ).
Sadly, that surgeon is now retired.
Out of all the surgeons we now have, I can think of one who might be  
persuadable to go into a head.

Nick Macartney
On 22 Mar 2009, at 13:49, LouIs N. Molino, Sr. wrote:

> Dumb question perhaps but I learn best when I ask dumb questions.
>
> Would any general surgeon say even an Attending at a typical  
> community type hospital have the knowledge, skills, and abilites to  
> do the emergent burhole that may or may not have helped in this case?
>
> Louis N. Molino, Sr. CET
> FF/NREMT/FSI/EMSI
> Typed by my fingers on my iPhone. Please excuse any typo's
> (979) 412-0890 (Cell)
> LNMolino at aol.com
>
> On Mar 22, 2009, at 8:39, "LouIs N. Molino, Sr." <LNMolino at aol.com>  
> wrote:
>
>> In 1981 I took my first EMT-a class at the time there was one EMT  
>> text. Punished by the AAOS. Folks seem to forget that while in it's  
>> infancy EMS was a surgical domain. Hell the best ED Doc's from my  
>> past were all cutters. Good General Surgons for the most part.
>>
>> Ah the good old days.
>>
>> Louis N. Molino, Sr. CET
>> FF/NREMT/FSI/EMSI
>> Typed by my fingers on my iPhone. Please excuse any typo's
>> (979) 412-0890 (Cell)
>> LNMolino at aol.com
>>
>> On Mar 22, 2009, at 8:30, "McSwain, Norman E Jr."  
>> <nmcswai at tulane.edu> 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  
>>> EXCLUSION of
>>> 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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Dr NJD Macartney
ICU Director
Chase Farm Hospital
The Ridgeway
Enfield
EN2 8JL
+4420 8375 1074

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