Re: Pt. Scenario

["Thomas M. Hansen" <thomasmhansen@hotmail.com>]

To play the devil's advocate, the term community hospital could mean many 
things.  I don't think trauma designations are the same throughout the 
country.  If you mean a community hospital that does not have in house 
anesthesia at all times, for instance, this would come into play.  Also, is 
it day or "after hours" when there may or may not be a surgeon (trauma 
surgeon, neurosurgeon, ortho) in house or in their office in the next door 
building.  What's available in the ED?  Moonlighting int. med. or fam. prac. 
docs or board certified er docs?  In general this pt should go to a (in our 
area) Level 1 trauma center given the scenario. But also, a Level 2 and some 
Level 3 centers have all the resources for excellent care.  Kind of comes 
down to knowing the local hospitals and their capabilities, IMHO.

tom hansen
fnp, ed
flight nurse, AF reserve

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