List Archives

Mon, 4 Feb 2002 13:38:48 -0500

This message is in MIME format. Since your mail reader does not understand
this format, some or all of this message may not be legible.

------_=_NextPart_001_01C1ADAB.2F0BA630
Content-Type: text/plain;
	charset="iso-8859-1"

Dr. Coats,

At the risk of waxing uppity (me?), I think the Cochrane Group's conclusions
in this regard are whacked.  

Prefaced by a lack of evidence in any direction (the reader is left to
regard this as unsettling), they nonetheless suggest that spinal
immobilization may result in preventable morbidity and mortality via airway
compromise.  They fail to admit that an absence of randomized controlled
trials is likely a reflection of the empirical value of spinal
immobilization.  A superior study would require half of spine-injured
patients to randomly go un-immobilized.  Love to see that presented to the
Human Subjects Committee.

"Because airway obstruction is a major cause of preventable death in trauma
patients, and spinal immobilisation, particularly of the cervical spine, can
[sic] contribute to airway compromise, the possibility that immobilisation
may increase mortality and morbidity cannot be excluded."

Hmm.  I think I follow.  Let me try one:

"Because serial killers are typically white males, and white men comprise
the majority of western neurosurgeons, there exists the possibility that
your local brain guy may have a freezer full of dismembered prostitutes."

Wow.  That's easy!  Gotta get me a consulting job.

Now, before we go comparing long boards to PASG's, let's be sure we've
zeroed the scales:

A long board is just a Big Frigging Splint (BFS).  Nobody ever promised much
more or less. 

PASG's were long promoted by the military--followed promptly by
manufacturers--under the unsubstantiated assumption that they accomplished
some sort of curious autotransfusion, thereby ameliorating hypoperfusion
with limited untoward effects. Each of these notions has been repeatedly and
scientifically debunked, while the humble claims of BFS's remain unblemished
(see paragraph #1).

I for one would resist packing away the long boards just yet.

Pret Bjorn, RN
Troublemaker

------_=_NextPart_001_01C1ADAB.2F0BA630
Content-Type: text/html;
	charset="iso-8859-1"

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=iso-8859-1">
<TITLE></TITLE>

<META content="MSHTML 5.00.2919.6307" name=GENERATOR></HEAD>
<BODY>
<DIV align=left><FONT color=#800000 face=Arial size=2>Dr. Coats,<BR><BR>At the 
risk of waxing uppity (me?), I think the Cochrane Group's conclusions in this 
regard are whacked.&nbsp; </FONT></DIV>
<DIV align=left><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV align=left><FONT color=#800000 face=Arial size=2>Prefaced by a lack of 
evidence in any direction (the reader is left to regard this as unsettling), 
they nonetheless suggest that spinal immobilization may result in preventable 
morbidity and mortality via airway compromise.&nbsp; They fail to admit that an 
absence of randomized controlled trials is likely a reflection of the empirical 
value of spinal immobilization.&nbsp; A superior study would require half of 
spine-injured patients to randomly go un-immobilized.&nbsp; Love to see that 
presented to the Human Subjects Committee.<BR><BR>"Because airway obstruction is 
a major cause of preventable death in trauma patients, and spinal 
immobilisation, particularly of the cervical spine, can [sic] contribute to 
airway compromise, the possibility that immobilisation may increase mortality 
and morbidity cannot be excluded."<BR><BR>Hmm.&nbsp; I think I follow.&nbsp; Let 
me try one:<BR><BR>"Because serial killers are typically white males, and white 
men comprise the majority of western neurosurgeons, there exists the possibility 
that your local brain guy may have a freezer full of dismembered 
prostitutes."<BR><BR>Wow.&nbsp; That's easy!&nbsp; Gotta get me a consulting 
job.<BR><BR>Now, before we go comparing long boards to PASG's, let's be sure 
we've zeroed the scales:<BR></DIV></FONT>
<DIV align=left><FONT color=#800000 face=Arial size=2>A long board is just a Big 
Frigging Splint (BFS).&nbsp; Nobody ever promised much more or 
less.&nbsp;<BR></FONT></DIV>
<DIV align=left><FONT color=#800000 face=Arial size=2>PASG's were long promoted 
by the military--followed promptly by manufacturers--under the unsubstantiated 
assumption that they accomplished some sort of curious autotransfusion, thereby 
ameliorating hypoperfusion with limited untoward effects.&nbsp;Ea</FONT><FONT 
color=#800000 face=Arial size=2>ch of these notions&nbsp;has been repeatedly and 
scientifically debunked, while the humble claims of BFS's remain unblemished 
(see paragraph #1).<BR><BR>I for one would resist packing away the long boards 
just yet.<BR><BR>Pret Bjorn, RN<BR>Troublemaker<BR></DIV></FONT></BODY></HTML>

------_=_NextPart_001_01C1ADAB.2F0BA630--

List Archives

For your convenience, find the Trauma List Archive Below

Spinal Immobilization question