EMS management/crush injury

[pjcabdds at mchsi.com]

Jago,
I will try to get some followup. It would help this thread. You ask the critical
question: was direct transfer necessary. Thanks for your reply.

--
Kind regards,
Phil
Phil Caropreso, MD, FACS
1813 Grand Avenue
Keokuk, Iowa, USA, 52632
pjcabdds at mchsi.com


----------------------  Original Message:  ---------------------
From:    "Jago Miloguz" <japrak at gmail.com>
To:      "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Subject: Re: EMS management/crush injury
Date:    Sun, 10 Jun 2007 12:52:40 +0000

> Phil do you have any info on the current st praesens of this patient?what
> are her dgs? was direct transfer really necessary?
> 
> 2007/6/10, pjcabdds at mchsi.com <pjcabdds at mchsi.com>:
> >
> > Thanks for your reply Tim.
> >
> > --
> > Kind regards,
> > Phil
> > Phil Caropreso, MD, FACS
> > 1813 Grand Avenue
> > Keokuk, Iowa, USA, 52632
> > pjcabdds at mchsi.com
> >
> >
> > ----------------------  Original Message:  ---------------------
> > From:    "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za>
> > To:      "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
> > Subject: RE: EMS management/crush injury
> > Date:    Sun, 10 Jun 2007 05:39:39 +0000
> >
> > > Phil
> > >
> > > We need more info - but if it has decreased time to definitive care (i.e.
> > your
> > > hospital would refer on) then there is no major critique. Having said
> > that you
> > > did have a team on standby and since this was a lim-only injury by
> > description,
> > > may have been managed by you definitively. Would take this up with the
> > > EMS-medical director, since this would constitute an EMS crew overriding
> > their
> > > Medical Control (you - they put you on standby; you should make the
> > call!).
> > > Having said all this I'm in another country, with different rules!
> > >
> > > 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 pjcabdds at mchsi.com
> > > Sent: Saturday, June 09, 2007 11:06 PM
> > > To: trauma-list at trauma.org
> > > Subject: EMS management/crush injury
> > >
> > >
> > > Colleagues,
> > > Opinions, comments, analysis, advice would be appreciated on the
> > pre-hospital
> > > management of this case:
> > > Adult woman, driver of a motorcycle, which was stopped at an
> > intersection in
> > > town (10,000 pop). Seven blocks from the hospital. A semi truck, hauling
> > a
> > > bulldozer type, heavy equipment, pulled up along side of the motorcycle.
> > > Restraining chain broke and the implement fell off of the truck,
> > crushing the
> > > woman's right leg beneath the tread of the equipment. Unable to get VS.
> > IV
> > > started. Patient awake. At least 30 minute extrication. Local, ground
> > EMS advise
> > > trauma alert. A full trauma team (boarded ERP, GS, anesthesia, OR crew)
> > all in
> > > house and waiting for patient. A helicopter was dispatched to the
> > hospital for
> > > likely transfer, after local evaluation and stabilization, to tertiary
> > center,
> > > 45 air minutes away. Ground EMS personnel diverted the helicopter to the
> > scene.
> > > The patient was transferred from the site. I have no other details.
> > > I will present this case at the local trauma committee meeting. I am
> > looking for
> > > help in organizing my thoughts. Thank in advance.
> > >
> > > --
> > > Kind regards,
> > > Phil
> > > Phil Caropreso, MD, FACS
> > > 1813 Grand Avenue
> > > Keokuk, Iowa, USA, 52632
> > > pjcabdds at mchsi.com
> > > --
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