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Sat Aug 22 17:00:13 BST 2009

My dear friends on trauma-list:  

The entire issue of C-spine collars, cervical fractures, cervical  
ligamentous injury, paralysis, and how to diagnosis critical injuries have been  
stuck in the teachings and technology of the 1970.    I have  recently been 
doing some literature searches, data analysis, and talking to  researchers in 
spinal cord injury.    I predict that we are on  the brink of a MAJOR 
SURPRISE to all of us.    I recently just  dropped my jaw and said, "Well I will be 
damned" after reviewing some startling  research.     Keep your eye out for 
something new to arise  and keep your mind open.      If my first 
impressions  (actually surprises) are born out, I will do all I can do to bring this  
surprise to the Las Vegas Trauma meeting in March.     

It takes a lot now days to surprise me and find something really  new.    
This may be it.     

k 

In a message dated 8/21/2009 2:26:00 P.M. Central Standard Time,  
drydok at hotmail.com writes:

Subject: Re: C-SPINE CLEARANCE AND ELEVATION OF HOB
>  Sorry if I seem obtuse

--> It's not you - just the angle of  the bed, when you flex it... ;-)

> the flexion in a head of  bed raise takes place at the hip. Why should 
that cause any extra  problems

--> Actually, it does not. It takes place at a  certain part of the bed, 
not the patient. If the patient then slides down the  bed, as many do, the 
flex point will now move up to the  spine...

Additionally, you'd have to be really very accurate to  make sure the 
patient only flexed at the hip joint, not the lower  lumbars...

However, if you are going to strap the patient very  solidly to the bed at 
all levels, so that he/she cannot slide, I suspect you  may be able to get 
away with flexing the bed, but I'm not sure why not just  tilt it straight 
with head up...

We do, when rarely required,  tild the trauma patient in a straight bed 
with head up (or down). I was not  aware of 30 degrees as a known limit for 
this. Not saying I'd wish to exceed  30, but what is the reason for this number 
being chosen - can anyone  enlighten?

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C-SPINE CLEARANCE - surprise