With respect, Adrian, if you don't think an A&E Consultant can make a difference to how well a trauma team works you perhaps could
usefully re-examine your approach. I have a videotape showing an orthopaedic SpR bickering with a surgical SpR for 21 minutes over a
patient. During that time, not a single person touched that patient. There was no A&E senior input. An A&E Consultant orchestrates,
pushes, bawls, and keeps the flow going. 21 minutes is quite long enough to complete your assessment and have the patient to
definitive treatment. The traumatised patient is the most difficult patient to assess and manage accurately and expeditiously. It's our
Whipples' or our paediatric switch. To abrogate that responsibility, "because it would be difficult in London" (what's wrong with living
in Hampstead for goodness' sake?) is simply an excuse.
I hope to look into this with a colleague. We have compared death rates at three hospitals, one with active Consultants, one with trauma
teams run in the traditional way and a third with a different approach entirely. There are very obvious differences. I won't spoil the
surprise by telling you what we found, but it was extremely interesting.
Best wishes,
Rowley Cottingham
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