autotransfusion

[DocRickFry@aol.com]

In a message dated 2/3/00 5:57:21 PM Eastern Standard Time, 
bonecrusher@orthotrauma.freeserve.co.uk writes:

<< Rick,the Good Book of ATLS says you should open the chest of anyone with a
 chest drainage of more than 200ml/hr.!  >>
No--not quite--read it again!
Then come back to us and tell us what it actually says
Also--as with any cookbook--it is a set of guidelines, parameters meant 
primarily for those who do not deal with trauma on a regular basis.  Like 
cardiologists with ACLS, and pediatricians with PALS, experienced trauma 
surgeons frequently deviate to some extent or another in given settings for a 
variety of specific factors involved in individual cases from these general 
guidelines.
In fact, it may easily happen that 1500cc-2 liters could accumulate in a 
Pleura-Vac quite quickly before a decision for the OR may be made and on the 
way up that blood could be infusing right back into the patient.  It could 
also be quite likely that 500-1000cc to 1500cc could come out of the chest 
and the bleeding completely stop--no surgery necessary--and all that blood 
can be quickly salvaged right there in the trauma center.  Both of these 
scenarios have happened to me many times
You seem to have gotten off your original assertions as you try to pick apart 
something different in each of my posts--I guess you must think I'm lying?  I 
would not do that
Perhaps you can sum up for us exactly why and with what you disagree with in 
my simple relation to you of the fact that simple autotransfusion can and is 
done in the trauma center without the need for a perfusionist--which is the 
assertion from you that I originally responded to in order to correct this 
misperception.
ERF