trauma activation and stratification

[JanyaUC at aol.com]

what a sensitive spot this conversation has hit ....
 
in our small level II trauma center we are struggling with these same  
issues.....although we have very clear cut protocols in effect to determine what  we 
do....it's a daily struggle
who's in charge? e.r. doc or surgeon? 
who's in charge of calling the activation? ..etc.
 
 
what we seem to forget in every discussion is this...what is in the  patients 
best interest?
 
our trauma pts usually fall into two categories...full trauma activation  
..in which everyone comes in..especially the surgeon, and the surgeon is in  
charge of the patient. then we have the modified trauma activation..in which  
specialties are called in as deemed by the er doc and the er doc is in charge of  
the patient. 
 
in my opinion it is best for the patient to have everyone and everything he  
may need to have a better outcome when he rolls into my trauma  bay.  
unfortunately that is clouded with power plays, egos and the  inability to play well 
with each other.
 
 
jan 
rn
 
 
In a message dated 10/3/2006 9:36:24 A.M. Pacific Daylight Time,  
japrak at gmail.com writes:

dell
l am not trying to underestimate any trauma surgeon at all. l  can imagine
just how extended their knowledge is, but presuming that  critical care
surgeon can deal with acute MI as good as with surgical  conditions, then we
should let the surgeons treat every disease there is.  and by no chance any
non-surgical physician can know about iniciative  trauma managment as much as
surgeon can know about non-surgical  conditions.
and the fact that EM physicians are dealing with trauma  patients every day
and the fact that they actualy went to med school and  residency where they
had subject such as surgery, critical care,  anesthesiology....means nothing
because after all they are not the all  mighty surgeons.
ante
PS.please don't interpret this as a attack on  surgeons, because l realy
admire to them,because all the significant and  challenging job they are
donig