Lack of INTEGRATED TRAUMA SYSTEM cost Richardson her life ? (complete)

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Larry's post is the reality:  Very few trauma surgeons are as involved at the medical direction level in this country as are the emergency medicine physicians.  
 
I believe that until such time that emergency physicians are trained to perform trauma surgery, trauma and acute care surgeons will always be needed.  That said, it is the SURGEONS which are letting themselves be "marginalized" for the reasons that Norm outlined.  There are now trauma fellowships that focus on training the emergency medicine physician to be a trauma surgeon proxy.  
 
I'm not sure if this is good or bad.  EM certainly has the enthusiasm and are running fast with the baton.  But there are a lot of unanswered questions with this approach.  
 
Ben Reynolds, PA-C
Pittsburgh, PA

--- On Sun, 3/22/09, Larry Torrey <LTorrey at maine.rr.com> wrote:

From: Larry Torrey <LTorrey at maine.rr.com>
Subject: Re: Lack of INTEGRATED TRAUMA SYSTEM cost Richardson her life ?
To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Date: Sunday, March 22, 2009, 1:19 PM

KMATTOX at aol.com wrote:
> ...With such a system, the paramedics
> in the  ambulance that finally did transport this patient would have been
in  communication with the TRAUMA SURGEON at the area regional verified trauma 
center for advice and orders.   This EMS vehicle then might have  administered
Hypertonic Saline on the way to Montreal Trauma Center...

Does anyone here actually work in a system where a trauma surgeon is online,
communicating with EMS prior to their arrival in a hospital? While this sounds
great, it also sounds the stuff of fantasy.

It is the rarest occasion that I have ever seen surgery interact with EMS
providers except during a patient hand-off in the trauma room.  I'm not
talking about surgeons being involved on a system-level, but on a provider-level
working with the medics and the services themselves.

If surgeons want more involvement, then I say 'Bravo, get involved!'.
As a long-time paramedic myself, the only thing I can find more difficult to
imagine that an EMS system not wanting a surgeon involved at their level is a
surgeon who wants to get involved at their level.

Larry, RN, EMT-P
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