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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