There's very robust data from the US from Donald Becker showing a
cut-off of four hours from time of injury to theatre for subdurals makes
a big difference to outcomes.
Anton
Staffs
[log in to unmask] wrote:
>
> Wasn't there something from the UK TARN group suggesting that outcomes are better with senior surgical involvement. There was certainly a paper suggesting senior resuscitators do it better. There are Guidelines from the RCS on time to theatre both for orthopaedics and general surgery. I presented them to my surgical teams on an audit day 2-3 years ago.
> I am recieving reports from them that
> ---------- Original Message ----------------------------------
> From: "Brown, Ruth" <[log in to unmask]>
> Reply-To: Accident and Emergency Academic List <[log in to unmask]>
> Date: Wed, 2 Mar 2005 07:51:28 -0000
>
> >Dear list
> >We are having difficulty in reconciling new rotas for Surgical SpRs with the requirements for early Surgical expertise for major trauma - not that we have an enormous amount here but even more reason to have a team that functions well. Currently our Surgical colleagues are on call from home - and may take up to an hour to get in.
> >
> >I think this will only get worse with H@N since my understanding is that the project aims to get as many senior docs off site as possible at night.
> >
> >Does anyone have either a comprehensive review of the effect of the presence of senior surgical decision makers in trauma, and a validated standard for the attendance time,
> >or evidence form existing pilots for H@N that there is no problem with this approach?
> >
> >I have read the RCS trauma guidelines, which are a bit woolly -"senior surgeon present" but no statement as to whether should be present when patient arrives or within 30 minutes or 2 hours into resus.
> >
> >thanks RUth
> >Ruth Brown FRCS FFAEM
> >Emergency Medicine Consultant
> >
> >
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