Hackensack hospital adding a trauma unit on wheels

[Michael A Duchesneau, MD]

I'm very much familiar with the differences, but the concept here
is advancing all types of Emergency Medical Care outside the hospital.




-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bjorn, Pret
Sent: Tuesday, December 05, 2006 9:31 AM
To: Trauma & Critical Care mailing list
Subject: RE: Hackensack hospital adding a trauma unit on wheels

I wasn't aware that Waveland, Mississippi was in New Orleans.  I guess
all Wal-Marts look alike. 

And Carolinas Med-1 is a mobile ED, whereas the HUMC project intends to
construct a traveling trauma SICU.  If you'd like to explore the
differences, I'd be happy to.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Michael A
Duchesneau, MD
Sent: Tuesday, December 05, 2006 9:19 AM
To: 'Trauma & Critical Care mailing list'
Subject: RE: Hackensack hospital adding a trauma unit on wheels

Thanks for your comments.
FYI, Carolinas Med-1 WAS in New Orleans after Katrina.


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bjorn, Pret
Sent: Tuesday, December 05, 2006 9:13 AM
To: Trauma & Critical Care mailing list
Subject: RE: Hackensack hospital adding a trauma unit on wheels

Dr. Duchesneau,

Consider for a moment that one man's "forward thinking" is another man's
"New Coke."  In this case, such has almost nothing at all to do with the
qualifications of individual clinicians in the field -- which most of us
didn't mention anyway.  

The problem instead is that this "innovation" is simply and utterly
counter-systematic.

On its face, it's an Emergency Preparedness Commedia Dell'arte: Let's
build a bunch of multi-million-dollar roller-hospitals and store them in
a big warehouse, just in case a city collapses.  When a city collapses
(ideally, not the city with the big warehouse), we'll suspend our
established processes and choke on our better instincts (for example, to
evacuate the danger zone), in favor of dusting off the trucks, stuffing
them with precious and highly experienced human cargo, and trundling
them into the conflagration, where they'll endanger themselves and their
patients (who, under the innovative model, are no longer en route to a
safe and fully operational REAL hospital miles distant, but rather
plugged into the back of an RV, dependent on generator power, limited
food and fresh water, and a very finite supply of equipment,
medications, and blood products).

Seven beds and an operating room?  Holy cow!  With just 3.5 million
dollars, we get to help SEVEN PEOPLE!  If only we had sent a few of
these to the New Orleans Convention Center after Katrina.  Doubtless
they would have been greeted as liberators and could have planted the
seeds of orderly society.

My suggestion: for the price of one Disastermobile that will probably
never be used, you could thoroughly train a couple of thousand
healthcare professionals in disaster triage and trauma care.  Or you
could buy a nice helicopter (or fifty ambulances) and save lives every
single freaking day. 

Pret


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Michael A
Duchesneau, MD
Sent: Monday, December 04, 2006 6:16 PM
To: 'Trauma & Critical Care mailing list'
Subject: RE: Hackensack hospital adding a trauma unit on wheels

It's really disappointing to see the lack of forward thinking here.

The presumption is immediately made that the staff on this unit will
be unqualified and dangerous. 

What evidence is there for this?

As a full time EMS Physician I run calls all the time, and hold all
necessary training, certification, and experience to be a team leader,
not
a liability.

Also, Emergency and Trauma medicine cannot stay stagnant, and new
innovations need to be welcomed, not attacked.

I am currently working on designs for several care models which raise
the
level of field medical care to new levels. 

The only difference with my plans are that they are financially
independent,
not relying on grants or subsidies.

My .02

Michael A Duchesneau, MD
Tampa, FL / NYC


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