Quote:
Originally Posted by Red Flag 1
Referal calls from anyone, including referring physicans, are a subjective event.
What was the mechanism of injury? Did you probe the wound? What are the last vital signs? Are there distal pulses? Is there distal perfusion? Are you able to control bleeding without using a torniquete? Is the patient alert? Can the patient sit up without hypotension? Can the patient speak and understand the English language? Has a surgeon at your facility seen the patient,if so, may I speak with him? What is the single driving reason you are sending this paitent to me?
From what is presented, air evac is in the cards. Information from nurses , or anyone that knows the case on the ground, is of great value to the flight nurse/crew. In that transient care is placed in the hands of the flight crew, they need all the information they can get!
My $.02.
Like to know how this turned out 
RF 1 |
Great questions, Red Flag.
The patient sustained a grinder injury to the left popliteal fossa. It is isolated and has sliced through the left posterior fossa. The physician had just rapidly bandaged the patient and did not "look deep" into the wound. He said the patient only lost a few hundred cc's of blood. Nothing about the scene and nothing about the blood loss in the car. Vitals were initially stated as "normal". As for distal pulses, the physician stated that they were normal and I "did not have to worry". They did not do orthostatics so I cannot comment. The patient is Spanish speaking with broken English. No surgeon there has seen the patient but I as the trauma surgeon at my institution am accepting the patient for transfer to our Level One trauma center. Again, the physician there tells me that he needs me to take him to the OR for closure and possible exploration but it probably does not go that deep. They do not have OR capabilities there interestingly enough.
Air Evac is an option as is ground. But . . . Yes, the nurses spoke to each other from hospital to hospital and that is where the "truth" gets told. Even the air crew nurses start calling our trauma center because everything is not as it appears and they have a very sick patient on there hands! They are calling for direction and to let us know they are coming in hot.
There is another response below. I will answer it and then we will continue on with the case!
Dutch