Emergency Room vs. Motorcycle Accident Patient

Careful here when you say "standard" then that means that all places that either don't do it or don't have the capacity aren't providing "standard" care.... CT is NOT the standard of care for spines at this time. It is an adjunctive diagnostic tool. The history and clinical exam are the standard (meaning everyone gets this), the plain films or CT are based upon your findings or further investigation. I refer you to research the Canadian C-Spine rules or the NEXUS criteria for imaging of the spine in trauma. These tools have been validated and thoroughly researched over the years, and Mechanism of Injury alone is not criteria for imaging the spine.....

Do we xray and CT more than we should - definitely.
Do some clinicians use xrays and CTs in lieu of poor assessment and inadequate clinical decision making -YES (I am guilty of this sometimes also I admit)....
But does that make it acceptable to connotate xrays and CT's of the spine as "standard" - NO

All I'm saying is just be careful to not get in the trap of thinking what is "standard" versus not.

In my level I, university/teaching, trauma center, 115 bed ER with 180,000 ER visits/year - this definitely is not standard care.

Hope this helps!
-MB

...see my other post: MOI in and of itself does not dictate the level of care

Mechanism of injury however, does indicate the level of trauma for the pre-hospital folks to relay to the accepting hospital.

At any rate to the OP - I hope your son is recovering. As a mom I am so sorry for the worry this has caused you.

And based on the information in the original post and care he recieved he was probably not at trauma center. If he was the state and the American College of Surgeons should be yanking their trauma designation.

Rj

I completely agree!

I'm so sorry you have had to go through this. I hope your son recovers quickly.

I agree, you should contact someone and report the care he received. Good luck, let us know how he's healing. Take care.

Jennifer

What is that hospitals trauma designation?? Level 1,2,3??

Does sound like he was triaged to a fast track area is he was seen by a NP from the start. Although his MOI would have made him a trauma ALERT at our hosptial and he would have been evaluated by the trauma team which consist of 3 surgery residents, & a staff ER physician. He would have gotten 2 large bore IV's, a foley and a NG. Chest and pelvis plain films in the ER room, and then to CT for head and c-spine. Followed by more plain films of T and L spine. If everything checked out OK, he probably would have gone to tub room in our burn center for debriebment. And probably an oberservation admisson, again due to the MOI, AND 3RD DEGEE BURNS.

...Not all NPs only work Fast Track....

Yes, I know. But the NP's and PA's I've worked with in level 2's and 3's over the years, have never been primary on a trauma pt.