Re: Pt. Scenario

[GRODRIANST@aol.com]

In the several level 1 trauma centers that I have worked in the, "board 
certified" trauma surgeons are always in the hospital and are present in the 
ER when critical pts. are brought in (based on pre-hospital report).
The residents, do in fact, generally do the initial assessments whith the 
attending in the room. If the attending did not initially respond they are 
available in house to be called down if needed.
I have worked with some outstanding ER physicians at local community 
hospitals, but the necessary resources for complicated trauma pts. are often 
times not immediately available. Mistakes are made and things are missed at 
all levels of care, the caregivers are, after all, only human and we are all 
fallible at times. 
With the initial mechanism and injuries described, in the original post, this 
type of pt. 8 times out of 10 would benefit from a trauma center. We can't 
x-ray or CT in the field to examine the extent of injuries, so as always it 
is better to error on the side of the pt. 

Stan Grodrian RN, EMT-P
Hermann Life Flight

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