most useful MD's at a scene

bigbaldguy

bigbaldguy

Former medic seven years 911 service in houston
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So if the pros on here were to list off the most "useful" MD specialists to have at the scene of a traumatic injury scene I was just curious who you would put at the top of the list. Obviously a ER doctor would top the list I assume.

What about a medical call with multiple issues happening Heart issue/respiratory/drug interaction ect.

In my experience in my day job most of the Docs I have had help have been only minimally useful but I know that not all specialists are created equal.
 
bigbaldguy said:
So if the pros on here were to list off the most "useful" MD specialists to have at the scene of a traumatic injury scene I was just curious who you would put at the top of the list.
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Depends on how bad the trauma was.

If it was bad, definately a critical care surgeon, vascular surgeon, general surgeon, or OB/GYN in that order.

If it was not so bad, an emergency physician or ortho surgeon.


bigbaldguy said:
Obviously a ER doctor would top the list I assume..
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Not if it were serious.

I would like to quote a very esteemed emergency physician's advice on serious trauma.

"The only purpose an emergency physician has in serious trauma is to wave good-bye to the patient on his way to surgery."


In the event of multiple medical issues with trauma, in order I want:

A critical care surgeon, anesthesiologist, A surgical specialist in the most pressing medical issue. (Cardiothoracic, Ob/Gyn, Neuro, etc.)

Contrary to popular belief, surgery doesn't require a theatre, it requires a knife, needle, and thread.
 
Here in DK we have anaesthesiologists that we can call to scenes with traumatic patients. That is the only specialists we can call to help out side the hospital.

Other wise it depends on the accident type.
 
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I mean a doctor is a doctor. They often don't identify themselves at a scene or even start care.. But with that said, a doctors general knowledge of biological chemistry with anatomy and physiology is larger by leaps and bounds than a paramedic. A cardiologist for a cardiac case? I'm not sure that specialty would make a difference because they don't have access to any unique interventions that the medics don't have. In a few select cases I'm guessing maybe some specialty might be able to utilize an ALS drug or infuse it in a way a medic can't by protocol? I'm not sure.. If someone wants to expand on that.
 
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And Veneficus.. Why not if it's serious? Many ER docs are surgeons.
 
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rwik123 said:
And Veneficus.. Why not if it's serious? Many ER docs are surgeons.
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Emergency medicine is not a surgical specialty.

They have specific surgical skills they can perform.

In surgery, experience counts for a lot. If given the choice I want somebody who cuts regularly over somebody who knows how to but doesn't very often.
 
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rwik123 said:
And Veneficus.. Why not if it's serious? Many ER docs are surgeons.
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Don't confuse Emergency Medicine physicians with Critical Care surgeons. The guy that typically takes your pt in the ER is an EM physician
 
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A physician is a physician

If Brown needs one, any one will do; Brown would rather have an anaesthetist than a general practitioner for a buggered airway ....

Remember, that consultant dermatologist has just as much education in foundation and clinical science as that first year house officer over there
 
MrBrown said:
A physician is a physician

If Brown needs one, any one will do; Brown would rather have an anaesthetist than a general practitioner for a buggered airway ....

Remember, that consultant dermatologist has just as much education in foundation and clinical science as that first year house officer over there
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While definately true, don't forget that at least in Europe, there is more emergency education in the foundation than in the US.

But all things considered, if I got to choose, I want the specialist.
 
Brown would want a Specialist (Consultant) physician in whatever ology is required most expeditiously however let us consider a good example here.

Last year a bloke was left at home by the Ambulance Officers and died 12 hours later from massive sepsis. The first year house surgeon, the consultant dermatologist and the specialist trainee in public health can all tell you about banded segs, phagocytosis and the clinical signs of infection as well as what broad spectrum empiricial antibiotics might be useful

Gosh this sort of talk makes Brown appear somewhat clinically competent? :D
 
One doctor to come on a random call? EM doc.

Trauma? Trauma surgeon
Medical? IM
 
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The one that let's me do my job. Honestly, most docs are more then welcoming to the EMS crew doing what they want/need to do.



But I can't really think of many times that a doc would be useful out in the field to the point that they'd jump on in.
 
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Linuss said:
The one that let's me do my job.


Honestly, most docs are more then welcoming to the EMS crew doing what they want/need to do.
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So you find no need for a Physician at a job?

Perhaps we should go tell all those BASIC and PRIME Ambulance Doctors here and in the UK
 
MrBrown said:
So you find no need for a Physician at a job?

Perhaps we should go tell all those BASIC and PRIME Ambulance Doctors here and in the UK
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Honestly, most of the time, no... especially since skill-wise, the stuff the docs do for HEMS in the UK are pretty much covered by ground and flight crews here anyhow, which is what they are used for primarily anyhow. Not to diagnose a difficult disease process... but to do chest tubes, or RSI, etc etc.


On the more complex, emergent, medical calls, the patient is best served by being in a hospital, not by a gung-ho Paramedic, Nurse, or doctor out in the field with limited tools and drugs (despite what can be done with those tools and drugs with the right know-how)



The circumstances where a doctor is of great benefit out in the field are very rare and are often limited to specialties.
 
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MrBrown said:
So you find no need for a Physician at a job?

Perhaps we should go tell all those BASIC and PRIME Ambulance Doctors here and in the UK
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Brown,

Haven't you heard?

Down in Texas paramedics are the most amazing providers available. They can do anything and are limited only by their ignorance and hubris.

They are truly legends in their own minds.
 
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Brown.. didn't you hear? No matter the circumstance, no matter the complaint of the patient, a doctor, regardless of area of study, will ALWAYS be better, by leaps and bounds, above lowly Paramedics and Nurses!


There has never been a doctor wrong in ANYTHING. They can mend a broken bone in the field with just an IV catheter, or restart a stopped heart just by looking at a patient. Atleast, apparently they can in Europe.


A patient will ALWAYS benefit from a doctor being on scene, no matter what!






Oh wait... that's right, I never did say Paramedics, let alone ones from a specific locale, were the best option in every and all situations, let alone most, many, alot, etc etc... but alas apparently I did.
 
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I have to agree with Linuss. Any doctor in the field will not be able to provide any better care than the paramedic with both using the same tools. Any specialty treatment would make no sense in an outside environment due to infection, lack of tools and equipment and lack of support.
 
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