Traumatic aortic transections and stents

[Ronald Gross]

Thanks Ken.  The rest of the study was normal.

>>> <kmattox at aol.com> 10/17/2007 6:39 AM >>>
I would consider it but wth the CT shown I would NOT.   There is far too little information on this one view to do anything to this patient at this point exept put him on afterload reduction agents while you complete the evaluation.   I cannot clear the ascending aorta and branch vessels.    

K


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-----Original Message-----
From: "Ronald Gross" <Rgross at harthosp.org>

Date: Mon, 15 Oct 2007 11:50:20 
To:"Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Subject: Traumatic aortic transections and stents


Folks,

A straw poll:  would anyone on this list place an aortic stent in a 21 year old male with a femur fracture and a transection shown in the attached ppt. ?

Ron

>>> "Ronald Gross" <Rgross at harthosp.org> 10/15/2007 9:43 AM >>>
Through the medical staff, develop the position of medical bed manager (aka bed czar) who will deal with such issues by simply admitting the patient to the service where that patient most appropriately belongs.  Tends to be a bit controversial at times, but for the most part, the attendings will usually agree with the decision after the fact.  The entire process MUST be subjected to PA/PI, and all "wrong" admissions need to be examined so that all can learn.

Ron

>>> "Andrew J Bowman" <andrewj.bowman at gmail.com> 10/14/2007 10:49 AM >>>
What then do we do about the attendings (fill in specialty here) who are
reluctant to admit a patient without the complete workup????

Andrew Bowman



Of note, there is I believe a disturbing trend in emergency medicine toward
'completing the workup' and perhaps this may explain some of the tendency to
keep patients in the ED for hours.
Chuck Havel
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