Pt Scenario

[Ramesh Nagappan <rameshnagappan@yahoo.com>]

Happy New Year one and all

Familiar scenario.  I would advocate flying the
patient to the trauma centre.

In my former life I was heavily involved in transit
care of the critically ill and well know the vagaries
of such situations.

As an intensivist with a bit of exposure to transit
care of the critically ill, I would recommend flying.

In this era of bean-counting evidence-based
fundamentalism, the literature will say that
air-transfer may not add anything to the
surface-transport.  What is good for a group of
patients (in terms of outcome) is not necessarily
applicable to the individual patient.

Irreconcilable difference between theory and practice
of life.  Sounds like the "theory of relativity" story
I heard sometime ago.  You are on a park bench and at
the other end is the World's most beautiful lady. 
Everytime she looks at you smilingly, you move half
the distance between you and her on the park-bench. 
Theortetically (and only theoretically) you may never
reach the woman!

cheers
Ramesh Nagappan

=====
Ramesh Nagappan, MD, FRACP
Critical Care Physician
Intensive Care Unit
Monash Medical Centre
Locked Bag 29, 246, Clayton Road, Clayton - 3168
Melbourne, AUSTRALIA
Fax: 61 3 9594 6878

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