Funny, thought that would get a response from Andy Lockey! I know, I've seen
several very good survivors from VF in the department, but I guess you see
my point. I figure the new ILS course "hits the mark" much better than ALS,
that's a good development by the resus council. Sorry, I'm straying from the
original thread again...
Adrian Fogarty
----- Original Message -----
From: "A S Lockey" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, July 28, 2002 4:39 PM
Subject: Re: 24 Hour 'Senior' Cover
> 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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