New Burn Centers in NYC and Mobile Surgical team

[Robert Smith]

I'm confused about a) the 30 "burn center" in NYC and b) the concept of a
mobile surgical team

A. I believe everyone on the list has made a commitment to reduce
radiological exposure. ( heh heh) Patients suffering severe burns from 1)
radioactive material would be - dead or soon to be. 2) biochemical ???? 3)
chemical - could probably be handled in ED and transferred.
	what are they expecting these "centers" to accomplish? Emergent life
saving burn care involves airway management, resuscitation and debridement.
Could general surgeons do the debridement? Definitive burn care requires a
whole lot of stuff that these centers are not going to have after whatever
training they get.

B. Patients "who won't survive transport to Level I centers" is one of my
pet peeves. If some one is dieing from an injury that requires immediate
surgical intervention and they won't live through a transport then they
won't survive waiting for the traveling surgeons to save the day either. How
does this save lives? Am I missing something? However long it takes the
traveling team to get there is how long it would take the patient to get to
an actual trauma center isn't it?

Rob Smith

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Moore677 at aol.com
Sent: Thursday, December 07, 2006 11:23 AM
To: trauma-list at trauma.org
Subject: Re: Hackensack hospital adding a trauma unit on wheels

Bill Long (Legacy - Portland) has been met with a lot of criticism in the
past regarding his mobile surgical transport team.  He takes his resources
to the outside hospital which has minimal or no resources.  These patients
will not survive transport to the Level I without rapid and aggressive
resuscitation and stabilization and potentially operative intervention.  Is
it financially feasible, well that is another issue?  Does it save lives, it
sure does!!  


Dell............


Forrest O. Moore, MD
Division of Trauma & Surgical Critical Care East Texas Medical Center 1020
E. Idel Tyler, TX 75703
Cell: (903) 279-2123

In a message dated 12/7/2006 10:14:24 AM Central Standard Time,
Rgross at harthosp.org writes:
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
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