Smash
Forum Asst. Chief
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We all know how important it is that patients get a c-collar and LSB if they have been in a car crash, witnessed a car crash, driven past a car crash, saw a car crash on the TV news, or heard about a car crash from an old college buddy whose wife's cousin was nearly in a car crash last week.
If we do not put a c-collar on and strap these patients to a LSB immediately, there is a 125% likelihood that their head will fall off, which, whilst making airway management easier, will definitely land you in court getting sued for elventybillion dollars, and/or your cert pulled.
We know this. This is Truth.
Imagine, then, my surprise; nay, outrage! at the following passage from some mouth-breathing, knock-kneed, pigeon-toed, sunken-chested, ivory-tower-dwelling rubber loving Barbie-thumper who fancies himself "Editor" of some rag called the "Journal of Trauma"
“…the more compelling question is whether there is a place for collars in emergent protection of the injured cervical spine or are they simply a gimcrack?
The incidence of second injuries to the spinal cord in the extraction of accident victims under the best of EMT performance is not known and would be difficult to determine. However, in an effort to minimize that incidence, paramedical gospel is the application of a cervical collar, maintaining the neck in in-line and in a neutral position. By definition, this gospel implies the deliberate movement of the neck to apply an orthotic known to be nonprotective. Furthermore, the neutral and in-line admonition implies that the patient’s neck position can be safely adjusted to “look better” without a shred of evidence that this might be a safer strategy than avoiding any unnecessary neck movement whatsoever….
…In a conclusion common to many small study reports, the authors recommend that more work should be done in this area. In my opinion that might be best in refinements of extraction methods with an eye to only that neck movement necessary to resuscitation, collar be damned.”
(URL=http://www.ncbi.nlm.nih.gov/pubmed/21217496]J Trauma, January 2011[/URL])
Reading the article to which he was referring, it seems that by placing a c-collar on a patient with an unstable fracture, we create 2 pivot points around which the spine can distract, potentially worsening injury when a patient is moved... allegedly! This of course follows on from the other nonsense that showed that the collar itself (even without movement) can cause distraction of up to 11mm between C1 and C2 when a fracture is present.
So please, comrades, ensure you do not read such propaganda, and continue to pass down the Teaching of the Collar for as long as EMS exists.
If we do not put a c-collar on and strap these patients to a LSB immediately, there is a 125% likelihood that their head will fall off, which, whilst making airway management easier, will definitely land you in court getting sued for elventybillion dollars, and/or your cert pulled.
We know this. This is Truth.
Imagine, then, my surprise; nay, outrage! at the following passage from some mouth-breathing, knock-kneed, pigeon-toed, sunken-chested, ivory-tower-dwelling rubber loving Barbie-thumper who fancies himself "Editor" of some rag called the "Journal of Trauma"
“…the more compelling question is whether there is a place for collars in emergent protection of the injured cervical spine or are they simply a gimcrack?
The incidence of second injuries to the spinal cord in the extraction of accident victims under the best of EMT performance is not known and would be difficult to determine. However, in an effort to minimize that incidence, paramedical gospel is the application of a cervical collar, maintaining the neck in in-line and in a neutral position. By definition, this gospel implies the deliberate movement of the neck to apply an orthotic known to be nonprotective. Furthermore, the neutral and in-line admonition implies that the patient’s neck position can be safely adjusted to “look better” without a shred of evidence that this might be a safer strategy than avoiding any unnecessary neck movement whatsoever….
…In a conclusion common to many small study reports, the authors recommend that more work should be done in this area. In my opinion that might be best in refinements of extraction methods with an eye to only that neck movement necessary to resuscitation, collar be damned.”
(URL=http://www.ncbi.nlm.nih.gov/pubmed/21217496]J Trauma, January 2011[/URL])
Reading the article to which he was referring, it seems that by placing a c-collar on a patient with an unstable fracture, we create 2 pivot points around which the spine can distract, potentially worsening injury when a patient is moved... allegedly! This of course follows on from the other nonsense that showed that the collar itself (even without movement) can cause distraction of up to 11mm between C1 and C2 when a fracture is present.
So please, comrades, ensure you do not read such propaganda, and continue to pass down the Teaching of the Collar for as long as EMS exists.
