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Mon, 4 Feb 2002 21:59:05 +0300 (Arab Standard Time)

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Hi trouble maker , do you know about a study that disapprove the conclusi=
on
of cochrane group=0D
=0D
ANOTHER TROUBLE MAKER=0D
=0D
 DR. ALAA ZIDAN   Orthopaedic surgeon&Team leader Accident&Emergency Dept=
=2E=20
Salmanyia medical complex,Manama, Bahrain=0D
=0D
-------Original Message-------=0D
=0D
From: trauma-list@trauma.org=0D
Date: Monday, February 04, 2002 09:43:24 PM=0D
To: 'trauma-list@trauma.org'=0D
Subject: RE: Spinal Immobilization question=0D
=0D
Dr. Coats,=0D
=0D
At the risk of waxing uppity (me?), I think the Cochrane Group's conclusi=
ons
in this regard are whacked.  =0D
=0D
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 airw=
ay
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 th=
e
Human Subjects Committee.=0D
=0D
"Because airway obstruction is a major cause of preventable death in trau=
ma
patients, and spinal immobilisation, particularly of the cervical spine, =
can
[sic] contribute to airway compromise, the possibility that immobilisatio=
n
may increase mortality and morbidity cannot be excluded."=0D
=0D
Hmm.  I think I follow.  Let me try one:=0D
=0D
"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."=
=0D
=0D
Wow.  That's easy!  Gotta get me a consulting job.=0D
=0D
Now, before we go comparing long boards to PASG's, let's be sure we've
zeroed the scales:=0D
=0D
A long board is just a Big Frigging Splint (BFS).  Nobody ever promised m=
uch
more or less. =0D
=0D
PASG's were long promoted by the military--followed promptly by
manufacturers--under the unsubstantiated assumption that they accomplishe=
d
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 unblemis=
hed
(see paragraph #1).=0D
=0D
I for one would resist packing away the long boards just yet.=0D
=0D
Pret Bjorn, RN=0D
Troublemaker
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   >
      <DIV>Hi trouble maker , do you know about a study that disapprove t=
he=20
      conclusion of cochrane group</DIV>
      <DIV>&nbsp;</DIV>
      <DIV>ANOTHER TROUBLE MAKER</DIV>
      <DIV>&nbsp;</DIV>
      <P>&nbsp;<STRONG>DR. ALAA ZIDAN</STRONG>&nbsp;&nbsp; Orthopaedic=20
      surgeon&amp;Team leader=20
      Accident&amp;Emergency&nbsp;Dept.&nbsp;&nbsp;Salmanyia medical=20
      complex,Manama, Bahrain</P>
      <P><STRONG></STRONG>&nbsp;</P>
      <DIV id=3DIncrediOriginalMessage><I>-------Original Message-------<=
/I></DIV>
      <DIV>&nbsp;</DIV>
      <DIV id=3Dreceivestrings>
      <DIV dir=3Dltr style=3D"FONT-SIZE: 11pt" <i><B>From:</B></I> <A=20
      href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A></=
DIV>
      <DIV dir=3Dltr style=3D"FONT-SIZE: 11pt" <i><B>Date:</B></I> Monday=
, February=20
      04, 2002 09:43:24 PM</DIV>
      <DIV dir=3Dltr style=3D"FONT-SIZE: 11pt" <i><B>To:</B></I> <A=20
      href=3D"mailto:trauma-list@trauma.org">'trauma-list@trauma.org'</A>=
</DIV>
      <DIV dir=3Dltr style=3D"FONT-SIZE: 11pt" <i><B>Subject:</B></I> RE:=
 Spinal=20
      Immobilization question</DIV></DIV>
      <DIV>&nbsp;</DIV>
      <DIV align=3Dleft><FONT face=3DArial color=3D#800000 size=3D2>Dr. C=
oats,<BR><BR>At=20
      the risk of waxing uppity (me?), I think the Cochrane Group's concl=
usions=20
      in this regard are whacked.&nbsp; </FONT></DIV>
      <DIV align=3Dleft><FONT face=3DArial color=3D#800000 size=3D2></FON=
T>&nbsp;</DIV>
      <DIV align=3Dleft><FONT face=3DArial color=3D#800000 size=3D2>Prefa=
ced by a lack=20
      of evidence in any direction (the reader is left to regard this as=20
      unsettling), they nonetheless suggest that spinal immobilization ma=
y=20
      result in preventable morbidity and mortality via airway compromise=
=2E&nbsp;=20
      They fail to admit that an absence of randomized controlled trials =
is=20
      likely a reflection of the empirical value of spinal immobilization=
=2E&nbsp;=20
      A superior study would require half of spine-injured patients to ra=
ndomly=20
      go un-immobilized.&nbsp; Love to see that presented to the Human Su=
bjects=20
      Committee.<BR><BR>"Because airway obstruction is a major cause of=20
      preventable death in trauma patients, and spinal immobilisation,=20
      particularly of the cervical spine, can [sic] contribute to airway=20
      compromise, the possibility that immobilisation may increase mortal=
ity and=20
      morbidity cannot be excluded."<BR><BR>Hmm.&nbsp; I think I follow.&=
nbsp;=20
      Let me try one:<BR><BR>"Because serial killers are typically white =
males,=20
      and white men comprise the majority of western neurosurgeons, there=
 exists=20
      the possibility that your local brain guy may have a freezer full o=
f=20
      dismembered prostitutes."<BR><BR>Wow.&nbsp; That's easy!&nbsp; Gott=
a get=20
      me a consulting job.<BR><BR>Now, before we go comparing long boards=
 to=20
      PASG's, let's be sure we've zeroed the scales:<BR></DIV></FONT>
      <DIV align=3Dleft><FONT face=3DArial color=3D#800000 size=3D2>A lon=
g board is just=20
      a Big Frigging Splint (BFS).&nbsp; Nobody ever promised much more o=
r=20
      less.&nbsp;<BR></FONT></DIV>
      <DIV align=3Dleft><FONT face=3DArial color=3D#800000 size=3D2>PASG'=
s were long=20
      promoted by the military--followed promptly by manufacturers--under=
 the=20
      unsubstantiated assumption that they accomplished some sort of curi=
ous=20
      autotransfusion, thereby ameliorating hypoperfusion with limited un=
toward=20
      effects.&nbsp;Ea</FONT><FONT face=3DArial color=3D#800000 size=3D2>=
ch of these=20
      notions&nbsp;has been repeatedly and scientifically debunked, while=
 the=20
      humble claims of BFS's remain unblemished (see paragraph #1).<BR><B=
R>I for=20
      one would resist packing away the long boards just yet.<BR><BR>Pret=
 Bjorn,=20
      RN<BR>Troublemaker<BR></DIV></FONT>
      <DIV>&nbsp;</DIV></TD>
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Spinal Immobilization question