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Sat Oct 17 15:31:13 BST 2009

Mark

See you there! (ITC)

Apart from tranmediastinal GSW there is a limited role for even CT in
penetrating trauma - especially stabs!

FAST is still the best option for the unstable - specifically blunt
trauma. They need to adopt this appropriately.

Tim
Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer University of KwaZulu-Natal Dept Surgery
Deputy Director - IALCH Trauma Service
Durban - South Africa
> As ever, well said Tim!
> The issue of TBCT is becoming quite a hot topic for discussion in the UK
> amongst trauma players and our radiology colleagues.
>
> One issue that we have noted is a distinct reluctance for our EM dept to
> train up staff in FAST as 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.
> Anaesthetic colleagues have noticed greater pressure to take unstable
> bleeding patients to CT as  FAST is not available or poorly supported by
> our surgeons through unfamiliarity and lack of use to guide them.
>
> However, as Tim suggests those with a higher ISS and no obvious site of
> bleeding or injury must justify the risk of neoplastic change.
>
> Hope to see u at ITC Tim!
>
> Regards
> Mark F
> UK

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