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Cajun and Selco, pardon me for butting in here but you guys really have me thinking on this one. I’m an ED nurse, and even now while the lights are on and the sheeple are fed and happy there are times when we have to send people out from my hospital and transfer them to a higher level of care. We get traumas on occasion. They usually get transferred to the city once stablized. We get CVA’s all the time. If it’s ischemic we handle it in house, but for subdural bleeds and whatnot we send them to the big hospitals with neurosurgeons and more resources. Same for kids since we don’t have a pediatric floor. Do you think that higher levels of care will exist at all in SHTF, or am I just wishful thinking?

I completely agree with you Cajun that some cases are going to be lost causes. We get those patients now that we all know aren’t going to be saved because of down-time, history, mechanism of injury etc., but we work the code anyway. But what do you think about keeping a couple ET tubes, ambu-bags etc. around for the instances when maybe all the person may need is a little time, or a trip to somewhere that still has a higher level of care functioning? Granted, I know that anyplace with the lights still on in a crisis is going to be overwhelmed with problems of their own, but what do you guys think anyway? It would undoubtedly be case to case decision making.