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<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2>Hi:</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2></FONT></SPAN> </DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff size=2>As a
medical "ethnic group" we are educated quite different from the rest
of the people. We can't just say "if I was the patient I would hope this or
this". Even as patients we think as health community people because this is what
we do all the time. In this way, we are able to understand and judge everything
with the eyes of a health worker. For example, look into the grieving process of
general people and compare it with the same situation in a member of the medical
community; even if you can identify the same steps, the evolution is quite
different in the later. This is also one of the reasons the general people is so
prone to start a legal process when the results of our treatments are not the
their expected ones even if those outcomes are between normal limits
to us. Do not expect the general people to view things the way we do. We do not
have the right to disturb their already shaken lifes with our personal hopes.
The trauma incident has already hurted enough this people.</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff size=2>I know
a lot about this because I work in a General Hospital were we treat most of the
poorest people in Chihuahua, México, like tarahumara natives from the Copper's
canyon. Most of this people can't read or write but they watch TV, which under
that circumstances creates an unrealistic view of life in their minds. I am
performing research regarding the informed consent process in this kind of
people.</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff size=2>I
agree with everybody regarding the futillity of CPR in trauma and that is the
reason to be in disagreement with the "training view" shown in this
discussion. I believe in the need for training in every health worker BUT
BEFORE being in the hospital or in the field. The very first time I
performed an emergent orotracheal intubation was during a cardiac arrest, in a
real patient but alone with two nurses younger than me. The patient did
well but I don't want any of my students today to be in that
same situation. The emergency room is not the place to have a
long talk with the grieving familiy of the victim regarding this "training
session". I am quite shure that in any of our emergency places I will be able to
find some other "training experiences" under a more ethical background and
specially, with more recoverable patients instead of spending time obtaining an
informed consent to perform a procedure on a virtually death
patient.</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2></FONT></SPAN> </DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2>Respectfully:</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2></FONT></SPAN> </DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff size=2>Manuel
Sáenz-Terrazas, M.D.</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff size=2>Staff
Surgeon</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2>Hospital General de Chihuahua Salvador Zubirán</FONT></SPAN></DIV>
<DIV><SPAN class=580422322-28082003><FONT face=Arial color=#0000ff
size=2>Chihuahua, Chih. México</FONT></SPAN></DIV>
<BLOCKQUOTE>
<DIV class=OutlookMessageHeader dir=ltr align=left><FONT face=Tahoma
size=2>-----Mensaje original-----<BR><B>De:</B> trauma-list-bounces@trauma.org
[mailto:trauma-list-bounces@trauma.org]<B>En nombre de </B>Stephen
R.<BR><B>Enviado el:</B> Jueves, 28 de Agosto de 2003 02:00
p.m.<BR><B>Para:</B> trauma-list@trauma.org<BR><B>Asunto:</B> AW: CPR in
Traumatic Arrest and a Question for Dr. Frykberg<BR><BR></FONT></DIV>
<DIV>
<DIV>
<P>Firstly, a very wise surgeon whom I worked with told me that you
should use every opportunity to learn and practice your skills even if it may
not benefit the patient directly, it will benefit others directly when they
are in need of that skill. I see more problems with not utilizing a poor
soul who is mortally wounded for practice, than I do with not doing
anything. Remember that we have implied consent to perform potentially
lifesaving actions in cases such as this, so the issue
of consent is neglible at best. If I was the patient I
certainly would hope that they would use me in any manner possible to improve
others care, even if they couldn't save me. </P>
<P>Secondly, Dr. Frykberg where are you from? I noticed you made a
comment about the difference between US and German trauma ("unfall"). I
was just curious as to whether you were in the States or
Germany.<BR></P></DIV>
<DIV><FONT face="Times New Roman, Times, Serif" size=4><EM>Stephen L. Richey,
CRT, EMT-I/D, ERT, FF </EM></FONT><FONT face="Times New Roman, Times, Serif"
size=4><EM></DIV></EM></FONT>
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