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Wed Oct 7 20:48:52 BST 2009

And NO it should have been!  Too bad they didn't grow up pre-CT like we did.  Then they would have been FORCED to think and - God forbid - actually do a real physical examination!!

Ron

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of McSwain, Norman E Jr.
Sent: Tuesday, October 06, 2009 6:05 PM
To: Trauma-List [TRAUMA.ORG]
Subject: RE: ABC - a different take

After the insertion of a chest tube for a GSW of the chest today, It was
very difficult to convince the ED resident that the chest radiograph
showed the chest tube in the correct position and the bullet pathway was
through the lung was medial to lateral (obvious on the film) therefore
the CT of the chest would provide us with no additional usefully
information. Whatever happened to thinking? Is this my senility to
believe that a physical examination, a simple chest radiograph and an
eye-scan coupled with thinking would properly assess care of the
patient? Oh and yes the vital signs were within normal limits as well. I
even touched the patient, felt warm, moist skin, that was pink and with
good capillary refilling time

They still wanted a CT. I said "no" to their unhappiness. They asked me
3 additional times. The answer to each was "NO"

Norman

Norman McSwain MD
Professor - Tulane Univ. SOM
Trauma Director - Charity Hospital
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Jose Luis Danguilan
Sent: Tuesday, October 06, 2009 3:39 PM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: ABC - a different take

The new ABC ----

A -- Airway
B -- Breathing
C -- CT scan :)

Jose Luis J. Danguilan, MD

On Wed, Oct 7, 2009 at 4:23 AM, Gordon S. Doig
<gdoig at med.usyd.edu.au>wrote:

>
> A = allocation concealment
> B = blinding
> C = complete follow-up
>
> Covers 90% of the major errors you will find in published RCTs.
>
> Gord
>
>
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ABC - a different take