And I thought that "acute Darwinian selection" was a term reserved for
riders of motorcycles (donor-cycles)
With the new system hospital mortality rates will certainly improve as we
will only be treating survivors.
(We already have some experience of this in Shropshire with a large
footprint of a catchment area into Wales!)
Mark P
> -----Original Message-----
> From: Paul Bailey [SMTP:[log in to unmask]]
> Sent: 06 December 2006 12:22
> To: [log in to unmask]
> Subject: Re: Emergency access - Clinical case for change: Report by
> Sir George Alberti
>
> It's got a certain attraction to it.
>
> Get critically unwell patients to roam around the countryside for a couple
> of hours in the back of an ambulance having a trial of viability. Those
> that respond favourably to a bit of bouncing around, normal saline and
> morphine survive their 'trial of viability' and are admitted to hospital
> after the window of opportunity for any meaningful intervention has
> passed.
>
> Those that require more serious and / or time urgent intervention who fail
> their trial of viability can just go straight to the morgue, thereby
> saving
> everyone a whole lot of hassle and expense.
>
> Sure, a few people who might have survived with rapid high quality care
> will
> not make it, but I'm sure this will be viewed as some sort of Darwinian
> natural attrition and the cost savings by not having to treat them all
> will
> more than make up for it.
>
> Surely.
>
> Paul Bailey
> Western Australia
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Andrew Webster
> Sent: Wednesday, 6 December 2006 5:47 PM
> To: [log in to unmask]
> Subject: Re: Emergency access - Clinical case for change: Report by Sir
> George Alberti
>
> Then when there is nothing the super A&E can do for you as you are outside
> the 2 hour window for stroke, your local hospital can not take you back
> because they have had to cut beds and staff as they have had financial cut
> backs. Your poor relatives then have to travel 3 hours a day to visit you
> while you wait 2 months for a bed in a nursing home. Sir Georges vision is
> good in theory but will fall down like so many ideas in practice.
>
> Andy
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Paul Bailey
> Sent: 06 December 2006 07:09
> To: [log in to unmask]
> Subject: Re: Emergency access - Clinical case for change: Report by Sir
> George Alberti
>
> Because,
> Let's face it, if you're critically unwell the back of an ambulance
> driving
> across the country for a prolonged period of time is just the place you
> want
> to be.
>
> Paul Bailey
> Western Australia
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC) A
> &
> E - SwarkHosp-TR
> Sent: Wednesday, 6 December 2006 1:56 PM
> To: [log in to unmask]
> Subject: Re: Emergency access - Clinical case for change: Report by Sir
> George Alberti
>
> I am also somewhat concerned by Sir George's comments that he would be
> happy
> travelling across the country if critically ill and if he deteriorated in
> the ambulance paramedics could sort it out; and that when he suggests all
> suspected MIs and suspected strokes travelling potentially long distances
> to
> get to specialised centres he does not seem to take account that this
> comes
> to about 2 million cases a year in England (i.e. those who require
> assessment by an experienced doctor rather than just those with a definite
> diagnosis).
>
>
> Matt Dunn
> Warwick
>
>
>
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