Re: Pre hospital blood draws & pissing contests

[Guest guest]

,

the spirit of a lively debate and not a " pissing >contes=>t. "

well said.

Because of certain genetic predispositions i find myself poorly equipped

for pissing contests generally...

The patient arm-banding ritual has come into being >to act=

>ually help and protect the patient. ><snip>

absolutely correct. The idea behind the banding ritual (great term) is

to be sure that the pt gets a compatible transfusion of blood or blood

products.

Your scenario is a very good one. It would not work in a small hosp such

as mine. At night, we have one lab tech on duty, & you had better hope

s/he is in a good mood & all the machines are working, or you're in for

a long night.

Also, are you prepared to take the responsibility of a blood

>transfusio=>n reaction because the wrong blood was given to the wrong

patient.

A scarey, ugly situation. Many dynamics here. If there is the slightest

question, the blood should be redrawn.

>Who i=>s best served-the patient who may be on dialysis for the rest of

his >life b=>ecause he was mis-identified, or the paramedic who may have

his >feelings hu=>rt because his blood specimen wasn't utilized?

hold on there. we all get hurt feelings, on & off duty. how we deal with

things is the difference between people I think. Perhaps the paramedic

wants to help the pt toward definitive care. Maybe s/he wants to help

out the (critiically overworked & understaffed) nurses in the ER.

As both nurse & paramedic, I can say that some of us may have a naughty

streak or two, but most of us truly mean well,

> Type specific blood can be made available in 10 minutes.

at trauma centers.

If

>uncross-matc=

>hed blood is given, the brunt of responsibility is on the physician,

>the la=

>b, and the hospital.

true enough, but the brunt of the consequences are on the patient.

>The ambulance crew may be transporting only one critically injured

>patient =>to the E.D. If there is only one EMS pt., it's easier to be

sure that the blood tubes came from this pt.

Also, the EMS in my area label the tubes as they are pulled.

>In case you are wondering about my experience level, I

<snip>

most impressive.

I too have some small experience in emergency care. All I int ended when

I explained about the blood tubes was education.I was not trying to

advocate a policy of routinely using prehospital blood draws for T & C.

I do not think it should be excluded, however, depending upon the

situation.

You state your points eloquently & you make a tremendous case for

transporting big bad trauma to a trauma center.

Jules

___________________________________________________________________

You don't need to buy Internet access to use free Internet e-mail.

Get completely free e-mail from Juno at http://www.juno.com/getjuno.html

or call Juno at (800) 654-JUNO [654-5866]

------------------------------------------------------------------------