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Wed Jun 27 14:37:27 BST 2012

Trauma cases are not being exclude.

// TS
"Aut viam inveniam Aut faciam"

"Omnibus per artem fidemque prodesse"

On Jun 27, 2012, at 5:13 AM, "William Bromberg" <brombwi1 at memorialhealth.com> wrote:

> It is not SCIP-based (which excludes trauma cases anyway, doesn't it?)
> 
> Sent from my iPad
> 
> On Jun 27, 2012, at 7:20, "Nancy D. Curdy" <leontdog at aol.com> wrote:
> 
>> 
>> I thought fecal contamination was an exclusion to the 24 hour ATB discontinuation....not prophy.
>> 
>> Nancy Curdy
>> Atlatna, Ga
>> 
>> 
>> 
>> -----Original Message-----
>> From: William Bromberg <brombwi1 at memorialhealth.com>
>> To: trauma-list <trauma-list at trauma.org>
>> Sent: Tue, Jun 26, 2012 10:49 pm
>> Subject: =?utf-8?B?UmU6IFNDSVAgZ3VpZGVsaW5lcw====?> 
>> 
>> I do. My partners are occasional backsliders. 
>> Bill Bromberg
>> Sent from my iPad
>> On Jun 26, 2012, at 18:29, "Tchaka Shepherd <tshepherdmd at hotmail.com>" 
>> tshepherdmd at hotmail.com> wrote:
>>> Hello All,
>> Quick question. 
>> How many of you are following SCIP guideline ( inf 3 )regarding  
>> iscontinuation of antibiotics within twenty four when you encounter a trauma 
>> atient with moderate to severe enteric spillage?
>> 
>> // TS
>> "Aut viam inveniam Aut faciam"
>> 
>> "Omnibus per artem fidemque prodesse"
>> 
>> On Jun 25, 2012, at 8:00 AM, KMATTOX at aol.com wrote:
>> 
>>> Prehospital Cardiac Arrest following blunt trauma.     Pronounce dead 
>>> unless part of an ongoing protocol with tight  review.     
>>> 
>>> Blunt trauma and arrest in the EC.     If EKG does nota  have a tight 
>>> rhythm , pronounce dead, unless there is a surgical protocol 
>>> 
>>> Blunt trauma and arrest anywhere.     NO External  cardiac compression, NO 
>>> ATLS drugs.     Will be  ineffective.   If there is to be a reversal it will 
>>> be something  surgical such as pericardial herniation, hemopericardium, 
>>> ruptured right artium,  etc.    
>>> 
>>> Any CPR and ACLS will only make the situation WORSE, and should prompt a  
>>> peer review and education of those who propose such an action.    
>>> 
>>> MANY MANY articles have been written on this subject and appear in the  
>>> trauma literature.   
>>> 
>>> k
>>> 
>>> 
>>> 
>>> 
>>> 
>>> 
>>> 
>>> In a message dated 6/24/2012 6:33:59 P.M. Central Daylight Time,  
>>> edcritcare at gmail.com writes:
>>> 
>>> Hi  Folks,
>>> 
>>> I have been a long-term lurker on this list.
>>> 
>>> I do a  podcast called the EMCrit Podcast, which covers Resuscitation,
>>> Trauma, and  Critical Care topics. [http://emcrit.org] It gets >100,000
>>> downloads per  month from EM, anesthesia, critical care, and  trauma
>>> practitioners.
>>> 
>>> One of my listeners can't convince her  attendings that giving CPR and ACLS
>>> medications to a blunt traumatic arrest  is not sound resuscitation. On
>>> literature search, there's not much  evidence. Physiologically, these
>>> interventions make no sense.
>>> 
>>> My own  practice is to perform bilateral finger thoracosotomies (chest  tube
>>> placement without actually placing the tube unless there is air or  blood
>>> return) and echo the heart for tamponade. If those two don't reveal  a
>>> reversible cause, we call the code.
>>> 
>>> I think this mirrors the  practice of most of my trauma colleagues.
>>> 
>>> But since there is not great  evidence, your expert opinion is the next best
>>> thing.
>>> 
>>> If you have a  minute and you have an opinion on this topic, call the
>>> podcast voiceline at  1-781-436-2748 and leave a voice message with your
>>> feelings. I will compile  them all and release them as a podcast. Make sure
>>> you state who you are and  where you work when leaving the message.
>>> 
>>> If you are shy or would rather  stick with the written word, reply to this
>>> post and I'll give voice to your  thoughts.
>>> 
>>> I know this topic has been discussed on the list before and  on
>>> trauma.orgas well, so I will definitely discuss those opinions  from
>>> the archives as
>>> well.
>>> 
>>> Much  thanks,
>>> 
>>> Scott
>>> 
>>> --
>>> Scott Weingart  <http://scottweingart.com>, MD
>>> 
>>> Associate  Professor
>>> 
>>> Director of ED Critical Care
>>> 
>>> Mount Sinai School of  Medicine
>>> 
>>> New York, NY
>>> ED Critical Care Blog & Podcast  <http://blog.emcrit.org>
>>> [image: YouTube]  <http://youtube.com/emcrit>  [image:
>>> Facebook]<http://facebook.com/emcrit> [image:
>>> Google Plus  Page] <https://plus.google.com/b/101796437135386808424/>  
>>> [image:
>>> Twitter] <http://twitter.com/emcrit>
>>> --
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> 
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