BEST CASE OF MY CAREER

Sun Jun 29 17:23:19 BST 2008

First, Sal thanks for the Case for us to review.   I was on duty  as well 
yesterday and also had a CAROTID injury, but we went directly from the  ambulance 
dock to the OR and did not have benefit of an angiogram.  

In your case:   We have basically ONE  view.     I cannot make out the 
"balloon" or what it  occludes.    You have asked for opinions as to "What to do  
NEXT?"     I see NO intracerebral circulation, but I think I  see ophthalmic 
vessels from the left external carotid circulation.    We do not have any 
description of the status of the patient now that left  external carotid is occluded. 
    If the patient is viable,  I would request of YOU, now that you are in 
the arteriogram suite to inject the  RIGHT carotid artery and look at the cross 
circulation.    If the  patient is CNS intact, and there is CROSS circulation 
with an intact circle of  Willis, I would ask you then totally occlude the 
Left Internal  Carotid.    I would like to know what your LEFT VERTEBRAL  
injection had shown.    If there is NOT an intact circle of  Willis and no cross 
circulation, then I have some other suggestions which will  come later.  

K Mattox.  

In a message dated 6/29/2008 11:11:01 A.M. Central Daylight Time,  
sjasmd at aol.com writes:

A 22  yo male sustained a left zone III neck stab wound that amputated his 
ear. He  exsanguinated in the field. Intubated, resuscitated, bleeding from ear 
wound.  Packing was unsuccessful. A Foley catheter was inflated in the wound 
with  reduction in bleeding. Angiogram requested shown below.

View  full size

how to  proceed

sal

-----Original Message-----
From: Kate  Curtis <Kate.Curtis at SESIAHS.HEALTH.NSW.GOV.AU>
To: Trauma &amp;  Critical Care mailing list <trauma-list at trauma.org>
Sent: Thu, 26 Jun  2008 7:03 pm
Subject: RE: Trauma education for Med-Surg and  ICU?

The College of Emergency Nursing Australasia has  developed a trauma
nursing course that has modules for ED, ICU and the  Ward.  It's quite
good and has an e-learning component
The link:  http://www.tnp.net.au/html/about.htm 

Kate

Kate Curtis RN,  PhD
Clinical Nurse Consultant Trauma
St George Hospital
Sydney
P:  +612 91133499 or 2686
Pager: +612 91131111 pager 019
F: +612  91133974

-----Original Message-----
From:  trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On  Behalf Of Milici, Justin J.
Sent: Wednesday, 25 June 2008 8:16
To:  'traumanurses at traumanurses.org';  'traumanurses at listserve.com';
'trauma-list-bounces at trauma.org';  'trauma-list at trauma.org';
'ena_trauma at neptune.serverside.net'
Subject:  Trauma education for Med-Surg and ICU?

See below..... Is anyone  familiar with any particular trauma education
for Med-Surg and ICU nurses??  We do a  trauma educational portion as
part of their internship and  orientation. Any thoughts??

Justin Milici, RN, MSN, CCRN, CEN, CFRN,  TNS Trauma Education,
Prevention/Outreach Coordinator Trauma Services - 11  Roberts Baylor
University Medical Center 3500 Gaston Ave.
Dallas, TX  75246
Office: (214) 820-6818
Fax: (214) 820-1086
Pager: (214)  344-3961
JustinM at baylorhealth.edu<mailto:JustinM at baylorhealth.edu>
________________________________
From:  LPressler at urhcs.org [mailto:LPressler at urhcs.org]
Sent: Tuesday, June 24,  2008 10:23 AM
To: Milici, Justin J.
Subject: Question

Hi  Justin,  I have been doing hospital wide education using a  program
called Trauma Library Sessions.  I have completed the sessions  several
times and have been looking for other educational offerings which  could
be taught to nurses from  med-surg to ICU regarding trauma. I  was
wondering if you had any suggestions.
Laura Pressler, RN
Trauma  Nurse Educator
________________________________
[cid:_2_0731DFDC07331DB8005480C386257472]
More than a day's  work. It's our life's work.
________________________________
Eleventh  Street Campus
1600 Eleventh Street
Wichita Falls, Texas   76301
Voice:
(940) 764-3088
Fax:   (940)  764-3611
lpressler at urhcs.org<mailto:lpressler at urhcs.org>

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