Hackensack hospital adding a trauma unit on wheels

[Ronald Gross]

Gotta say that, sarcasm aside, Pret is absolutely correct.  This mobile
doc-in-the-box is counterintuitive.  It also fails to ascribe to the
very basics of trauma care, and that is to bring the patient as quickly
to the place with the most resources, not to bring a few resources to
the place where they will quickly be overwhelmed, overused and thereby
useless!  I bet Frykberg would have a stroke with all of this.

Let me see, now......I am looking at something that is round, has a
hole in the middle, and can be put on a heavy stick with the identical
round thing on the other end of the stick onto which I can put something
and roll along very easily.  Why, I just reinvented the wheel.  Sounds
like what these "medical innovators" want to do.

Just my 3 cents (inflation and all.......)

Take care,
Ron

>>> "Bjorn, Pret" <pbjorn at emh.org> 12/5/2006 9:12 AM >>>
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 &amp; 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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