Operating Room Resuscitations

[William Bromberg]

Mark,

There is no way to "stabilize" an unstable trauma patient who needs the OR outside of the OR. The only thing you can do in the ED is place lines and give fluid. This is the WRONG thing to do to a hemorrhaging patient before you STOP THE BLEEDING.

As far as I'm concerned the ED is the place to go to figure out where the patient should ultimately be sent. If this is already known AND there is a bed/table available at that location the time in the ED should be minimal (if any at all).

Sadly, many places don't have an instantaneously available ICU bed, angio suite or even an OR suite and in those cases the ED is the least bad place to be. But if you're working someplace where the ED is better at hemorrhage control than the OR and  better at resuscitation than the ICU or OR along with caring for the thousands of non-traumatic run of the mill ED visits either you work someplace with an awful OR/ICU or a VERY unusual ED.

>>> Mark Harvey <cometomark at hotmail.com> 1/31/2008 10:37 AM >>>

First posting on this list so go easy on me been sitting back and reading for a long time, apologies if I'm missing the point here.
 
Taking patients straight to the ICU/HDU for Resus is a grand idea, however in the 5 minute pre alert you get from the Ambulance for the patient to be expected in the hospital it would take nothing but a miracle to magic the ICU/HDU bed from thin air. A&E resus rooms are designed to take the patients in stabilise and ship out, whilst the faffing is going on the bed is made ready and ICU can calmly take the patient in with open arms.  
 
Slightly annoyed with the notion that an A&E department has no part to play in the Emergency care of patients.
 
Mark