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Old 03-30-2009, 12:08   #11
swatsurgeon
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Join Date: Jul 2004
Location: Phoenix, AZ
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remember, sealing was created for the least educated providing care in the field. This discussion was really for academic purposes. If you seal the wound and didn't need to, okay, if you sealed the wound and it did need it, okay.....not enough training "across the board" to allow people to make that decision all of the time undar all circumstances, i.e., basic medic, typically not talking about docs or 18D's with a greater fund of knowledge.
An open wound BTW is a safe wound just like a 'simple' PTX....air exchanges and based on negative pressure ventilation (our usual method of breathing) vast majority of patients will do fine....if any problems, BVM or intubate and provide positive pressure ventilation then the open chest is a100% non-issue.
Controlling contamination is another but related issue.
ss
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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