Totally heretical, Adrian, seeing as how they are designed for the immediate
period after the arrest (how many of those do we see in A&E? Virtually
none - hence the fact we don't tend to see survivors.) Now if you had an MI
... God forbid....think of those poor nurses having to look after you ;-)
.... And had an arrest during thrombolysis, then I think you would be glad
of someone who was all fired up with enthusiasm after an ALS course!
Andy
(press the right button and I rant!)
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Adrian Fogarty
Sent: 28 July 2002 13:58
To: [log in to unmask]
Subject: Re: 24 Hour 'Senior' Cover
----- Original Message -----
From: "Dr P Munro"
Subject: Re: 24 Hour 'Senior' Cover
> Even if I do not go in for things, at least I know
> about them and I dont hear that someone was in Resus for two hours getting
> an ex-fix on followed by a laparotomy from my consultant colleagues the
next
> day.
I see your point Phil, although in your criteria list you simply wrote
"trauma", so it was difficult for me to interpret what exactly you meant by
that, and for that matter how do the SHOs and nurses interpret this?
> For single or double consultant departments (as during my consultant
> colleagues holidays) we simply raise our threshold for going in but NOT
for
> being informed of what is going on.
Personally I don't really wish to know about every case that passes through
my department, even big cases, as long as they are managed reasonably well.
Of course it's nice to hear about the interesting ones, the ones that went
very well or went very badly for example, but the next day will do just
fine. I don't really want to hear about them in the middle of the night just
because "it's the rules", but I'm happy to be telephoned if someone
genuinely wants my assistance.
> We do not attend for
> standard cardiac arrests during the night as by the time we get there it
> would be pointless but for complex blunt trauma and situations where there
> are multiple sick patients in the department we DO make a big difference
and
> we SHOULD be there.
Fair enough, this might work for you or your department, but as Meeky says,
one size does not fit all. Although slightly off the subject Phil, I think
there's little point in attending "standard" cardiac arrests during the day
even, except to suggest stopping! I still haven't seen a single survivor of
an arrested patient following out-of-hospital arrest in six years as a
consultant, and before the "self-fulfilling prophecy" protests pour in, I'm
including the ones that I didn't manage and who had maximal resus. Of course
I could blame ALS courses for raising false expectations, but that would be
heretical, wouldn't it?
Adrian Fogarty
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