Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Mythological Observation of the Day – 1

Kelly Grayson writes Philosophical Observation Of The Night . . . about putting a cervical collar on a snowman.[1]

I wrote the following comment –

You got a snowman with a broken neck for your birthday? 🙁

The problem is that we have to fit our patients to our equipment, no matter how much harm that causes. Procrustes would be proud.

Procrustes?

bandit from Attica who physically attacked people by stretching them or cutting off their legs, so as to force them to fit the size of an iron bed.[2]

Kelly had a birthday. Yay!

What does Procrustes have to do with this?

A while back, in AD’s comments, Bobball described a backboard as Satan’s Hammock.[3]

Satan’s Hammock could also describe a Procrustean bed.

Our backboards are 2 sizes fit all – adult and pediatric. Our collars have a few more choices, but nothing that seems appropriate for many of our patients.

Feel free to criticize my pathetic attempt at a snowman – and the hat (poor hat, probably should be included in the Mechanism Of Injury).

Sure, we can immobilize anyone.

Never say fail!

Just get ‘er done!

Frosty would be better off with a scarf for support, rather than with this torture device rigid cervical collar.

I know – Very funny with the snowman, but we don’t do that with real patients.

Of course not.

We do real damage.

Better?

Worse?

Just as dangerous?

Probably more dangerous, if you consider that I cut the snowman’s head off to put the collar on.

Or less dangerous, since the snowman was never alive.

No snowmen were hurt in the creation of these images.


Picture credit.[4] Click on the image to make it larger.

I forget where I recently saw the following comment (I am paraphrasing) –

“With every other bone, we splint it in the position of comfort/position of function. With the spine, we force the spine to fit to the backboard and the neck to fit the collar.”

This observation does appear to be true.

bandit from Attica who physically attacked people by stretching them or cutting off their legs, so as to force them to fit the size of an iron bed.[2]

 

We are not Spartacus – We are Procrustes!

 

I think that the reason we harm people this way is that we refuse to think about what we are doing, because if we did think about it, we could not justify what we do. I do not believe that we are really sadists, gleefully inflicting harm on our patients.

Footnotes:

[1] Philosophical Observation Of The Night . . .
A Day in the Life of an Ambulance Driver
Article

[2] Procrustes
Wikipedia
Article

[3] Spinal Immobilization: You Make the Call
A Day in the Life of an Ambulance Driver
Article

Bob needs to do some blogging of his own, rather than just dropping insightful comments in blogs.

[4] Extrication collars can result in abnormal separation between vertebrae in the presence of a dissociative injury.
Ben-Galim P, Dreiangel N, Mattox KL, Reitman CA, Kalantar SB, Hipp JA.
J Trauma. 2010 Aug;69(2):447-50.
PMID: 20093981 [PubMed – indexed for MEDLINE]

.

Comments

  1. I fear for you. Soon the EMS Grand Inquisitor will come for you. The only question for this heretic then is strappado or rack? And will you confess your heresy?

    • Can’t say, clowns will eat me,

      I fear for you. Soon the EMS Grand Inquisitor will come for you. The only question for this heretic then is strappado or rack?

      I’m more of a rack person. Stretches and loosens the back.

      And will you confess your heresy?

      Of course. I post my heresies every day. 🙂

      What I won’t do is deny the truth.

      .

  2. Satans Hammock. Thats funny. Frosty isnt that bad, just a little early in the season. Maybe a witch or vampire would have been better.

    Still, it amazes me how people can still insist that this treatment is benefiting anyone. I mean just viewing a few of the posts around the EMS blogosphere should be enough to put a stop to this until proven otherwise.

    • Jim,

      Satans Hammock. Thats funny. Frosty isnt that bad, just a little early in the season. Maybe a witch or vampire would have been better.

      Satan’s Hammock was not my idea, but I love it.

      Vampire? Wooden stake through the heart or place them on a wooden/plastic spine board. It should work almost as well. A witch ordinarily strapped to a wooden stake for burning, but now strapped to a wooden/plastic spine board for burning. No significant difference.

      Still, it amazes me how people can still insist that this treatment is benefiting anyone. I mean just viewing a few of the posts around the EMS blogosphere should be enough to put a stop to this until proven otherwise.

      Few in EMS read blogs on a regular basis. Few seem to care about whether spinal immobilization does more harm than good. They seem to assume that immobilization is good, because they are true believers.

      Some people make up some nonsense about knowing what a jury will decide. Nobody knows what a jury will decide.

      .

  3. “Satan’s Hammock”

    +1

    If only I had a dime for every time I’ve heard the “every one gets boarded and collared” speech from the protocol quoters.

  4. Why is it that those that are so often right, or at least have a really good point, are demonized, terrorized and made out to be the antithesis of a good (fill in your profession of choice here) mainly because they challenge or simply question that what is presented as the absolute truth with no proof behind it? I’m assuming you’ve been made out to be the bad medic that just can’t accept that those in charge “know best” and you should just trust their judgment, correct?