trauma-list Digest, Vol 46, Issue 21

[Andrew J Bowman]

Dr. Arreddy,

Were you a member of the group that did the ACLS course for Apollo Hospitals
in August, 1998 with Dr. Ravinder Surikanti of the US?

Andrew Bowman

----- Original Message ----- 
From: "ramalinga reddy" <drarumalla at yahoo.com>
To: <trauma-list at trauma.org>
Sent: Friday, April 27, 2007 8:01 AM
Subject: Re: trauma-list Digest, Vol 46, Issue 21


> hi fiona
>     individual responses are highly variable to certain drugs-
>   as anaesthetist i know pts. arrested following a half tab of
domperidol,1mg of midazolam iv.
>   morphine deaths were too often and the same has gone out of usage in our
country-
>      Dr ARREDDY chief of nuro anaesthesiology. sks nuro hospital
.hyderabad india.
>
> trauma-list-request at trauma.org wrote:
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> Today's Topics:
>
> 1. RE: advice (Hardcastle, Tim, Dr )
> 2. RE: Rabid bears (Bryan Karla)
> 3. Damage Control (Claudia Baptista)
> 4. Re: Damage Control (kmattox at aol.com)
> 5. FW: Trauma legislation update (Bjorn, Pret)
> 6. RE: Damage Control (Robert F. Smith)
> 7. RE: Trauma legislation update (Robert F. Smith)
> 8. Gov Corzine & TRAUMA CENTERS (KMATTOX at aol.com)
> From: "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za>
> Subject: RE: advice
> CC: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> Date: Fri, 13 Apr 2007 13:05:02 +0200
> To: <plklopper at webmail.co.za>
>
> Peter
>
> Was the hernia repair open or laparoscopic? Did he look "bled out" - one
of the possibilities is a femoral arterial injury with retroperitoneal blood
tracking causing this pain picture.
>
> Let us know what the autopsy shows!
>
> Since you are also from South Africa, feel free to mail me off-list if
there is "local" related issues you may need advice on in this case.
>
> Tim
> Dr T C Hardcastle
> M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
> Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
> ATLS instructor and DSTC Cape Town Course Director
> Intern program Coordinator: Surgery
> M.Med (Emergency Medicine) Executive Committee member
> Clinical Head (Director): Diana Princess of Wales Trauma Unit
> Division of Surgery (General) Room 4064
> Department of Surgical Sciences
> Tygerberg Hospital / University of Stellenbosch
> PO Box 19063
> Tygerberg 7505
> Western Cape
> South Africa
> e-mail: tch at sun.ac.za
> Cell: +27824681615
> Office: +27219389281 or 4911 pager 0302
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Peter Klopper
> Sent: Friday, April 13, 2007 7:14 AM
> To: 'Trauma & Critical Care mailing list'
> Subject: RE: advice
>
>
>
> Hi Fiona
> I am a 100% sure it was morphine . all drugs that get administerd gets
> double chek and also the schedule 7 drugs are counted cheked and written
in
> to the habirforming register with 2 nurses signing , one who is a rnpost
> mortem was done yesterday so we will know what the results of he death
was.
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
> On Behalf Of fiona wallace
> Sent: 12 April 2007 10:20 PM
> To: Trauma & Critical Care mailing list
> Subject: RE: advice
>
> Are they 100% certain it was morphine given?
>
> Could it have been a drug mix up?
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Jenny Moncur
> Sent: 11 April 2007 11:43
> To: Trauma & Critical Care mailing list
> Subject: Re: advice
>
>
> pulmonary embolus?
>
> ----- Original Message -----
> From: "Peter Klopper"
>
> To: "'Trauma & Critical Care mailing list'"
> Sent: Wednesday, April 11, 2007 3:25 PM
> Subject: advice
>
>
> > Hi every one I need some advise and would appreciate all input I can
get.
> > I
> > am nurse in a private hospital. I was called to a resus in one of the
> > wards,
> > young male patient , 20 years old. Had an inguinal hernia repair
> > yesterday,
> > complained of back pian associate with hypoxia and also abdominal pian,
15
> > mg morphine given imi as prescribed by he surgeon, ten minuts later he
was
> > in full arress no signs of anaphalaxis or rash noted, he had morphine in
> > theatre for pain. Do you think it can be anephalixis or even a aortic
> > aneurism. Hes mother is a nurse and also a friend. I advise her to have
a
> > post mortem , to have closure to this unfortunate incedent. Please give
me
> > your input I would appreciate aal.
> >
> > Thank you
> >
> > Peter
> >
> > --
> > trauma-list : TRAUMA.ORG
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>
> From: "Bryan Karla" <Karla.Bryan at HCAhealthcare.com>
> Subject: RE: Rabid bears
> Date: Fri, 13 Apr 2007 08:35:16 -0500
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
>
> Dr. Hardcastle,
>
> Thank you for all your help. I do understand that the information is for
> rabies in general. I agree, unfortunately, our society is forcing us to
> do the CYA more and more. I think you'll be interested to know that when
> I presented the information I've received from you and our state
> epidemiologist to the trauma surgeon involved, he completely blew my
> off. His comment was something to the effect that it was overkill to
> treat this patient as he's never heard of a rabid bear before.
>
> I did access the CDC website and printed the information available
> there.
>
> I saw in the paper yesterday that it wasn't an elk carcass but a moose
> carcass that was nearby. The patient didn't know it was around. Fish and
> Game said it looked like a natural death.
>
> The patient had a degloving scalp injury, lacerations on the forehead,
> back and buttocks from claw marks. The patient apparently curled up and
> played dead. The bear went away after the initial mauling and he got up
> to go back to the house, but the bear apparently wasn't too far away and
> came after him and mauled him again. He was smart enough to play dead
> again, and when the bear was finished with him, he belly crawled back to
> the house.
>
> Karla
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Hardcastle, Tim, Dr
>
> Sent: Thursday, April 12, 2007 23:00
> To: Trauma & Critical Care mailing list
> Subject: RE: Rabid bears
>
> Karla
>
> My pleasure to assist. Realise the references are NOT specific to bears
> - just rabies - the virus is the same anyhow! Unlike Charles Krin, I
> cannot access the CDC site (semi-restricted for non US-subscribers?), so
> could not get you that data. I agree with Pret - if in doubt, give the
> prophylaxis. I don't think the issue here is that they know it is
> rabies, rather they are being cautious -it may just be good old CYA!
>
> Tim
> Dr T C Hardcastle
> M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
> Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU) ATLS
> instructor and DSTC Cape Town Course Director Intern program
> Coordinator: Surgery M.Med (Emergency Medicine) Executive Committee
> member Clinical Head (Director): Diana Princess of Wales Trauma Unit
> Division of Surgery (General) Room 4064 Department of Surgical Sciences
> Tygerberg Hospital / University of Stellenbosch PO Box 19063 Tygerberg
> 7505 Western Cape South Africa
> e-mail: tch at sun.ac.za
> Cell: +27824681615
> Office: +27219389281 or 4911 pager 0302
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Bryan Karla
> Sent: Thursday, April 12, 2007 8:43 PM
> To: Trauma & Critical Care mailing list
> Subject: RE: Rabid bears
>
>
> Thank you Dr. Hardcastle,
>
> I will look up the reference. This was a grizzly bear. A man heard his
> dog barking, went out to check on it, and there was the bear! The bear
> attacked and did not leave, even when EMS got there. Apparently, there
> was a fresh elk kill nearby that he was protecting. Fish & Game left the
> kill and set a trap. We haven't yet heard if the bear has been trapped.
>
> I spoke with our state epidemiologists--one an MD, the other a vet. Both
> agreed that the patient should be treated prophylactically until the
> bear is caught and tested (even though there have been no known cases in
> Idaho or Wyoming). I passed the information on to the trauma surgeon
> involved.
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Hardcastle, Tim, Dr
>
> Sent: Thursday, April 12, 2007 08:14
> To: Trauma & Critical Care mailing list
> Subject: RE: Rabid bears
>
> Karla
>
> Did a Medline search - surprisingly little re: protocols, but
> identifying the virus early is possible by rapid PCR testing. This can
> identify infected patients early.
>
> The swab DNA needs to go to the conservation service research labs - to
> identify the bear - they should have such laboratories!
>
> Look also at: Vet Clin North Am Small Anim Pract. 2001 May;31(3):557-72,
> Rabies postexposure prophylaxis. Human and domestic animal
> considerations, by Fearneyhough MG. This may help.
>
> Regards
> Tim
> Dr T C Hardcastle
> M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
> Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU) ATLS
> instructor and DSTC Cape Town Course Director Intern program
> Coordinator: Surgery M.Med (Emergency Medicine) Executive Committee
> member Clinical Head (Director): Diana Princess of Wales Trauma Unit
> Division of Surgery (General) Room 4064 Department of Surgical Sciences
> Tygerberg Hospital / University of Stellenbosch PO Box 19063 Tygerberg
> 7505 Western Cape South Africa
> e-mail: tch at sun.ac.za
> Cell: +27824681615
> Office: +27219389281 or 4911 pager 0302
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Bryan Karla
> Sent: Thursday, April 12, 2007 3:30 PM
> To: trauma-list at trauma.org
> Subject: Rabid bears
>
>
> Last night we had a patient come in who had been mauled by a grizzly
> bear--no, not the first we've ever had. Today we had a call from a fish
> and game conservation officer who asked us if we have a policy for
> testing for rabies on these patients (we do not). He also stated that
> there are pending lawsuits all over the country on behalf of patients
> who have been mauled by rabid bears and died. Families are suing fish
> and game and the hospitals because their loved one was not tested for
> rabies. He would also like us to swab these patients for possible DNA
> testing to help them in identifying the bears when/if they are caught.
> My questions: how soon can a patient be tested for rabies and have a
> positive test? What type of test is there (other than IgG)? Does anyone
> have any kind of policy or protocol for testing these patients that they
> would share? If you swab the wounds, to whom do you send the swabs for
> analysis? Any other suggestions you can give me would be greatly
> appreciated.
> Karla Bryan, RN, BSN
> Trauma Services Coordinator
> Eastern Idaho Regional Medical Center
> 3100 Channing Way
> Idaho Falls, ID. 83403-2077
> 208-227-2027
> Fax: 208-227-2032
> This e-mail and any files transmitted with it may contain PRIVILEGED or
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> immediately purge it and all attachments and notify the sender by reply
> e-mail or contact the sender at the number listed.
>
>
> Karla Bryan, RN, BSN
> Trauma Services Coordinator
> Eastern Idaho Regional Medical Center
> 3100 Channing Way
> Idaho Falls, ID. 83403-2077
> 208-227-2027
> Fax: 208-227-2032
>
> This e-mail and any files transmitted with it may contain PRIVILEGED or
> CONFIDENTIAL information and may be read or used by the intended
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>
> From: "Claudia Baptista" <claudiabaptista at hotmail.com>
> Subject: Damage Control
> Date: Fri, 13 Apr 2007 13:50:16 +0000
> To: trauma-list at trauma.org
>
>
>
>
>
>   Hello everybody!
>
>    I´m working at a presentation about Damage Control Surgery.
>    I´m a Anesthesiology resident, so i´d like to get some information
about specific aspects of the intra-operative period. I found a lot of
papers about the surgery, but only one about the anesthesia (Of course, I
have thousand about the lethal triade!).
>
>    Could you advise me some of the latest articles?
>
>    Thank You!!
>
>
>
> ---------------------------------
>   MSN Busca: fácil, rápido, direto ao ponto. Encontre o que você quiser.
Clique aqui. From: kmattox at aol.com
> Subject: Re: Damage Control
> Date: Fri, 13 Apr 2007 14:12:41 +0000
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
>
> For anesthesia and damage control, avoid giving pressors and crystalloids
to falsely elevate the Blood Pressure and pop the clot. Anesthesiologist
like to see a highish BP on their record and for Damage control surgery, I
like to see a systemic BP of 80/- or below.
>
> K
>
>
> Sent via BlackBerry, return via KMattox at aol.com
>
>
> -----Original Message-----
> From: "Claudia Baptista"
> Date: Fri, 13 Apr 2007 13:50:16
> To:trauma-list at trauma.org
> Subject: Damage Control
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
> From: "Bjorn, Pret" <pbjorn at emh.org>
> Subject: FW: Trauma legislation update
> Date: Fri, 13 Apr 2007 10:15:48 -0400
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
>
> For U.S. trauma care providers: please contact your legislative
> delegates. Contact info below.
>
>
>
> Pret Bjorn, RN
>
> Bangor, ME USA
>
>
>
>
>
> TO: Coalition for American Trauma Care Advisory Council Organizations
> and HRSA Stakeholders
>
>
>
> FROM: Marcia Mabee, MPH, PhD; Executive Director, CATC
>
>
>
> Please see the message below from Adrienne Roberts at the American
> College of Surgeons (ACS). An advocacy letter urging House and Senate
> Appropriators to provide $12 million in FY 2008 appropriations for the
> Trauma-EMS program is now posted on the ACS legislative action site.
> The link to the site is provided below. Please forward to your members
> and please use this opportunity to send a letter to your Senators and
> Representative!!! ALSO, please review the attached ACS letter urging
> for sign on by your organization -- DEADLINE COB APRIL 17TH.
>
> ______________________
>
>
> Just wanted everyone to know that the College has posted a letter of
> support for $12 million for the Trauma-EMS Program in the FY 2008
> L-HHS-E approps bill on our Legislative Action Center. Please feel free
> to direct any of your members to this site as well to send letters to
> the Hill. Thanks!! The link is http://www.capitolconnect.com/acspa/
>
> From: "Robert F. Smith" <rfsmithmd at comcast.net>
> Subject: RE: Damage Control
> Date: Fri, 13 Apr 2007 12:04:18 -0400
> To: "'Trauma &amp; Critical Care mailing list'" <trauma-list at trauma.org>
>
> I know there are several anesthesiologists on the list. I don't understand
> why they use pressors, ever. I would think it just gives a false sense of
> security and makes it hard for the surgeon to know where the patient is,
> phyisiologically. In fact it might obscure the decision to move to damage
> control mode if that wasn't initially the thought.
>
> R. Smith
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
> On Behalf Of kmattox at aol.com
> Sent: Friday, April 13, 2007 10:13 AM
> To: Trauma & Critical Care mailing list
> Subject: Re: Damage Control
>
> For anesthesia and damage control, avoid giving pressors and crystalloids
to
> falsely elevate the Blood Pressure and pop the clot. Anesthesiologist like
> to see a highish BP on their record and for Damage control surgery, I like
> to see a systemic BP of 80/- or below.
>
> K
>
>
> Sent via BlackBerry, return via KMattox at aol.com
>
>
> -----Original Message-----
> From: "Claudia Baptista"
> Date: Fri, 13 Apr 2007 13:50:16
> To:trauma-list at trauma.org
> Subject: Damage Control
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
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>
>
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>
>
> From: "Robert F. Smith" <rfsmithmd at comcast.net>
> Subject: RE: Trauma legislation update
> Date: Fri, 13 Apr 2007 12:06:14 -0400
> To: "'Trauma &amp; Critical Care mailing list'" <trauma-list at trauma.org>
>
> $12 million. How pathetic!
>
> R. Smith
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
> On Behalf Of Bjorn, Pret
> Sent: Friday, April 13, 2007 10:16 AM
> To: Trauma & Critical Care mailing list
> Subject: FW: Trauma legislation update
>
> For U.S. trauma care providers: please contact your legislative
> delegates. Contact info below.
>
>
>
> Pret Bjorn, RN
>
> Bangor, ME USA
>
>
>
>
>
> TO: Coalition for American Trauma Care Advisory Council Organizations
> and HRSA Stakeholders
>
>
>
> FROM: Marcia Mabee, MPH, PhD; Executive Director, CATC
>
>
>
> Please see the message below from Adrienne Roberts at the American
> College of Surgeons (ACS). An advocacy letter urging House and Senate
> Appropriators to provide $12 million in FY 2008 appropriations for the
> Trauma-EMS program is now posted on the ACS legislative action site.
> The link to the site is provided below. Please forward to your members
> and please use this opportunity to send a letter to your Senators and
> Representative!!! ALSO, please review the attached ACS letter urging
> for sign on by your organization -- DEADLINE COB APRIL 17TH.
>
> ______________________
>
>
> Just wanted everyone to know that the College has posted a letter of
> support for $12 million for the Trauma-EMS Program in the FY 2008
> L-HHS-E approps bill on our Legislative Action Center. Please feel free
> to direct any of your members to this site as well to send letters to
> the Hill. Thanks!! The link is http://www.capitolconnect.com/acspa/
>
>
>
> From: KMATTOX at aol.com
> Subject: Gov Corzine & TRAUMA CENTERS
> CC:
> Date: Fri, 13 Apr 2007 12:29:40 EDT
> To: trauma-list at trauma.org, ccm-l at ccm-l.org
>
> The following has just been posted to a NATIONAL news network blog site.
> Anyone on this list can use this initiative to communicate with local and
> federal persons. We are all grateful for the dedicated trauma team at
Cooper
> Hospital in Camden, New Jersey. Thank you for being there and continue
your
> good work.
>
> k
>
>
> Cooper Hospital in Camden New Jersey is recognized as one of the best
trauma
> centers in the country. It has been repeatedly stated that the very best
> trauma center in the greater Philadelphia area is the one in Camden New
> Jersey. The Governor is fortunate that one of the jewels of the nation's
trauma
> and disaster Integrated Collaborative Network was there for him when he
needed
> it. Ironically, these trauma centers are struggling for support for their
> infrastructure, surgical critical care recognition within the trauma
center
> network and incorporation into the regional EOC networks of our disaster
> preparedness and response. New Jersey has NOT followed its neighbor to the
> north, Connecticut, in structuring its medical disaster response on top of
an
> existing integrated trauma system. Governor, here is a chance to build on
> something good that is already in place.
> Kenneth L. Mattox, MD
> Houston
> _kmattox at aol.com_ (mailto:kmattox at aol.com)
>
>
>
> ************************************** See what's free at
http://www.aol.com.
>
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