Chris Montera, Scott Keir, Dr. Dave Ross, Sam Bradley, Patrick Lickiss, and I discuss the lack of evidence of any benefit from spinal immobilization.
Immobilization or not that is the question: EMS Garage Episode 156
Any standard of care that does not have evidence of benefit needs to have an expiration date.
What do we do that causes the most stress on an unstable spinal fracture?
Placing a cervical collar on the neck and strapping the patient to a board increases the stress on any unstable spinal injury.
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Why do we let a superstition become the Standard Of Care?
Because we can’t tell the difference between superstition and medicine.
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There is no evidence that spinal immobilization ever provided any benefit to anyone.
There is evidence that spinal immobilization doubles the rate of disability among people with spinal injuries – exactly the people it is supposed to protect.[1]
Spinal clearance protocols do cut down on the pain and suffering of those without spinal injuries.
Spinal clearance protocols make it more likely that the people with spinal injuries will be endangered by manipulating their spines into rigid EMS collars and onto rigid boards.
Making the patient fit the board, rather than making the board fit the patient, is not good medicine. It does not even make sense.
Without evidence of safety, spinal immobilization should be stopped.
Without evidence of benefit, spinal immobilization should be stopped.
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Also listen to – A Change of the Dogma – If spinal immobilization helps only one . . .
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Footnotes:
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[1] Out-of-hospital spinal immobilization: its effect on neurologic injury.
Hauswald M, Ong G, Tandberg D, Omar Z.
Acad Emerg Med. 1998 Mar;5(3):214-9.
PMID: 9523928 [PubMed – indexed for MEDLINE]
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