tag:blogger.com,1999:blog-4505990433916682663.post7403099557510638180..comments2024-03-13T02:04:31.476-04:00Comments on Paramedicine 101: Prehospital Spinal Clearance Part IIAdam Thompson, EMT-Phttp://www.blogger.com/profile/18107359165856983910noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-4505990433916682663.post-26086267816827732912009-06-17T02:59:19.995-04:002009-06-17T02:59:19.995-04:00Take your time, brother, I still have not covered ...Take your time, brother, I still have not covered the tip of this iceberg (this site), and perhaps will never be able to get through everything here.Shaggyhttps://www.blogger.com/profile/10687847155700323439noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-90676024100310707632009-06-12T21:53:00.323-04:002009-06-12T21:53:00.323-04:00I completely agree with all that you stated. As I...I completely agree with all that you stated. As I said, I was pretty skeptical of most of the statements made by that paper. I'm not done with this topic, but I am taking a pause for the moment. As always Shaggy, your comments are appreciated.Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-4172002029512306792009-06-11T04:11:00.178-04:002009-06-11T04:11:00.178-04:00Okay, I am commenting without looking up the cited...Okay, I am commenting without looking up the cited works referred to in your first cited work by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, so I am shooting from the hip here.<br />One quote was: <br />"The chief concern during the initial management of patients with potential cervical spinal injuries is that neurologic function may be impaired due to pathologic motion of the injured vertebrae. It is estimated that 3% to 25% of spinal cord injuries occur after the initial traumatic insult, either during transit or early in the course of<br />management."<br />ESTIMATED, based upon what evidence. I just don't like that word ESTIMATED, and I really am curious as to where they got their estimates. If anything, they can be just hypothesizing.<br />"Multiple cases of poor outcome from mishandling of cervical spinal injuries have been reported." I would like to see these cases and if direct cause and effect can be shown. What was the mishandling and can we determine from this that it was from lack of spinal immobilization via long board that led to these poor outcomes?<br /><br />"Over the last 30 years there has been a dramatic improvement in the neurologic status of spinal cord injured patients arriving in emergency departments. During the 1970's the majority (55%) of patients referred to Regional Spinal Cord Injury Centers arrived with complete neurological lesions. In the 1980's, however, the majority (61%) of spinal cord injured patients arrived with incomplete<br />lesions. This improvement in the neurologic status of patients has been attributed to the<br />development of Emergency Medical Services (EMS) initiated in 1971, and the pre-hospital care"<br />This seems to me to be just a correlation. Yes, contrary to RM, I correlations hold weight with me, but correlation does not necessarily prove cause and effect. We have seen the first time this year the lowest rate of MVC related deaths since the early 60s. Can we attribute that to EMS. Umm, no. Improved safety features in cars, stepped up enforcement, especially with seatbelts, etc. take center stage here. EMS may be a very small factor. The same thinking applies with the statement that immproved neurological findings in spinal injuries arriving in the ED. Can we really attribute that to EMS practice of spinal immobilization? Are we sure there are no other factors to consider for these improved results?Shaggyhttps://www.blogger.com/profile/10687847155700323439noreply@blogger.com