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

- Rogue Medic

Destroying a car to pretend to protect against spinal cord injury

 

 

This car was not damaged in the original collision.

This car was not even involved in the original collision.

This car was destroyed by fire and EMS in order to pretend to protect the spines of the people who had walked to the car.
 

Firefighters cut the roof off a woman’s undamaged car to rescue two people she gave shelter to following an accident.[1]

 

Yes, the patients did develop neck pain while sitting in the car waiting for police/fire/EMS to arrive, but would getting out of the car, without cutting the roof off, have increased the likelihood of a spinal injury becoming worse?

We don’t know. there is no evidence, but the lawyers tell us that they are afraid of that risk.

Why are we taking medical advice from lawyers?

Because we do not know what we are doing.
 

Injured people with pain from their injuries probably do a much better job of protecting their own injuries than by allowing a bunch of people playing with various implements of destruction to move them.
 

A spokesman for the South East Coast Ambulance Service said: “While the pair were sheltering in the car they developed neck pain.

“Paramedics explored every opportunity to get them out of the vehicle. However, in the end they had to get the fire service to cut the roof off and take them out on back boards.

“We can only apologise to Mrs Dunlop for the inconvenience of that.”[1]

 

No. You can pay her for the damage you did to her car. This was damage done to protect the agency from liability. They should be held accountable for the damage.
 

We act as if the patients’ reactions to cutting the car apart around them will not be putting as much strain on any potentially unstable neck injuries as having the patients get out of the car on their own.

People, who have no experience being in cars being cut apart around them, will probably flinch at the sounds of extrication equipment tearing apart a car around them.

People, who do have experience being in cars being cut apart around them, will also probably flinch at the sounds of extrication equipment tearing apart a car around them.

Why pretend that there is reason to believe otherwise?

Why pretend that muscular movement from flinching is any less significant than what the patients would cause by getting out of the car on their own?

Any movement of the car is also going to result in movement of the necks of the occupants.

Is there any evidence that self-extrication causes damage to an unstable spinal cord?

Is there any evidence that we provide any protection to patients by extricating them our way?

This is another example of how far we will go to protect a traditional treatment with no known benefit.
 

We don’t know and we don’t want to know.
 

At Street Watch: Notes of a Paramedic, there is a description of the continuing fall from grace of “spinal immobilization” – Another Nail in the Board. Go read it.

At Mill Hill Ave Command, there is a review of a recent study of the methods of extrication from vehicles and the amount of movement of the cervical spine – In order to protect the c-spine, should we stop helping?. Go read it.

Footnotes:

[1] Good Samaritan’s car destroyed after pair given shelter
8 January 2013 Last updated at 08:22 ET
BBC News Sussex
Article

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Comments

  1. Absolutely brilliant.

  2. Wow.

    Just…. wow.

  3. if the neck is where the issue is thought to be, then is there no collar that can be put on just the neck to immobilise just the neck? then, the patient would be able to get out of the car on their own.( I’m assuming some form of immobilization is necessary. Obviously, if immobilization is unnecessary…)

    but yeah, if I owned that car, I would be mad if all i got was an apology. sorry, but an apology and a new car, thank you. ( new car because that kind of damage can’t be repaired, and that looks like a fairly recent car.)

  4. I am very surprised at this; but then again, it does appear the UK is still somewhat quite conservative when it comes to spinal precautions.

    Although having said that, it certainly is possible to take somebody out of a car without taking the roof off.