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Fri Oct 16 20:01:00 BST 2009

From: atacc.doc at btinternet.com
> The issue of TBCT is becoming quite a hot topic for discussion in the UK amongst trauma players and our radiology colleagues. 

--> In our place (UK as well) it was a joint push by BOTH radiology AND EM to bring enough evidence to start this. Unlike a few issues on which we've had disagreements in the past, this one has elicited VERY LITTLE inter-departmental angst. Indeed, it has brought the two departments even closer together.

> One issue that we have noted is a distinct reluctance for our EM dept to train up staff in FAST

--> In our ED ultrasound training had to take a back seat for a while when we worked hard to cope with other priorities.

> they now find it far easier to just request a CT in cases such as penetrating trauma that may warrant a quick ultrasound and then theatre

--> I am not certain that you have chosen the best example for when ultrasound would be ideal - penetrating trauma... It is not at all common for penetrating trauma to be our indication for TBCT!

> Anaesthetic colleagues have noticed greater pressure to take unstable bleeding patients to CT

--> As already stated - the solution is a rapid CT and LOCAL, so the patient does not need to be "taken"...

> as FAST is not available or poorly supported by our surgeons

--> Funny thing is that, since we've had this closer relationship with radiology around TBCT and they "live among us" for trauma now, we suddenly find we DO have someone who can do FAST right there! We still, of course, do a CT and our evidence, as stated, indicates we are doing better than before...

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