Ideal ED length of stay?

[Roy Danks]

Mr Richey,
 
You were out of line.  Go look in the mirror at your arm patches.  I don't think they have "Doctor" on them.  And if you said "f---you" to your deputy med director, you should be fired.  It's not your call.  You over-stepped your boundaries by miles.  The ultimate responsibility for that  patients lies in the hands of the receiving physician.
 
I know this is going to generate lots of responses and I look forward to the opportunity to defend my position.
 
I don't know where you are "practicing", but I would guess it's not Houston.
 
Dr. Mattox's system obviously is more  efficient than many.  But I stand by my previous statement that except in the  most rare circumstances does it matter if you spend 10 to 20 min in the trauma bay.  We do, many do and our stats bear out the fact that our high ISS  patients do as well or better than national benchmarks.
 
We too have a dedicated elevator to the OR, but our preference is to see the patient and make some quick decisions.  We do not see the volume of penetrating trauma that Dr Mattox sees.  Most do not see that volume.  But we do our fair share.  And, prior to being here (Wichita) I was in Kansas City (KU) where we saw a moderate to large volume of high velocity penetrating trauma.  We didn't whisk them to OR from the ambulance bay and our survival, again, was well in line with national numbers.
 
Dr Mattox wants literature...I would ask for data to prove that 10 to 20 minutes is too long in the  trauma bay.  Does the "Golden Hour" exist or  does it not?  I am under the  impression it doesn't.  What is the magic time?  I don't know.  I don't know who knows.
 
So, I stand by my previous post that the patient that I presented would go to our trauma bay, get a pelvic wrap and two chest tubes and would do just fine, with an average LOS and above average outcome.
 
And, as a paramedic, you need to learn that your knowledge base is limited by your education and experience.  I was a medic in the field in a very busy system for 10 years prior to going to medical school.  I didn't know what I did not know until I was way gone from the field.  I am very active in EMS education and I will share your remarks (with your name and any identifiers removed) with a cadre of associates, both in and out of EMS to see what they would do with you.
 
K...your  move...
 
 
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