"Standards" of EMS and Trauma Center Care

[KMATTOX at aol.com]

I would agree with Dr. Ursic, that ideally, EMS, Trauma, CriticaL Care, and  
Acute Care Surgery would be "standardized."   However, among the  trauma 
centers in Houston (There are only two level I, and 8 Level II), there is  not 
agreement as to even standards of care regarding fluid management,  hypothermia, 
and continuity of care for simple hand and wrist  fractures.      
 
One major problem is that each "trauma surgeon" believes that her/his  
particular approach should be the standard for their community.    Indeed, as our 
government and HHS is now discovering, there are often more than  one, two, 
three, or even 10 acceptable and standard approaches to one particular  clinical 
problem.   The differences are  judgement.      
 
We are discovering that the "BEST PRACTICES" developed by hospital  
non-physicians are often punitive and regulatory for control  purposes.     
 
Soooooooooooooo
 
How do we reach agreement as to what would be the standard. ??
 
k



**************************************See AOL's top rated recipes 
(http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)