List Archives

Sun Aug 23 14:37:45 BST 2009

Several studies done (some mentioned previously and another from here) have not demonstrated additional Neurological deteriation after the initatial injury that were related to immpblization or lack thereof. No reason to use c-coller.
Norman

Typed by the thumbs of
Norman on his BlackBerry 

Norman McSwain, MD
Tulane Univ Surgery
504 988-5111

----- Original Message -----
From: trauma-list-bounces at trauma.org <trauma-list-bounces at trauma.org>
To: trauma-list at trauma.org <trauma-list at trauma.org>
Sent: Sun Aug 23 07:48:37 2009
Subject: Re: trauma-list Digest, Vol 74, Issue 27

Question if I understand what your saying  If the patient has a GSW to the neck do not use a c-collar. What if they were shot with a small caliber\medium to high velocity gun in the neck and ricochet up and down the spinal column. Please explain for educational reasons
Thanks Donald
Sent via BlackBerry by AT&T

-----Original Message-----
From: trauma-list-request at trauma.org

Date: Sun, 23 Aug 2009 12:00:23 
To: <trauma-list at trauma.org>
Subject: trauma-list Digest, Vol 74, Issue 27

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Today's Topics:

   1. RE: C-SPINE CLEARANCE - surprise (htaed_rd at 123mail.org)
   2. RE: C-SPINE CLEARANCE - surprise (McSwain, Norman E Jr.)
   3. Re: Preprocedure NPO in the ICU (Ian Seppelt)
   4. Vanishing in Midair, where's Trooper 2? (James Richardson)
   5. RE: C-SPINE CLEARANCE - surprise (htaed_rd at 123mail.org)
   6. Re: C-SPINE CLEARANCE - surprise (Forrest Robleto)
   7. Re: C-SPINE CLEARANCE - surprise (Jules)
   8. Re: C-SPINE CLEARANCE - surprise (Gustavo E. Flores)
   9. RE: C-SPINE CLEARANCE - surprise (McSwain, Norman E Jr.)
  10. RE: C-SPINE CLEARANCE - surprise (htaed_rd at 123mail.org)
  11. RE: C-SPINE CLEARANCE - surprise (Scott Beaudoin)
  12. Cx collar and GSW (Christos Giannou)

----------------------------------------------------------------------

Message: 1
Date: Sat, 22 Aug 2009 17:54:42 -0400
From: htaed_rd at 123mail.org
Subject: RE: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID: <1250978082.6111.1331134279 at webmail.messagingengine.com>
Content-Type: text/plain; charset="us-ascii"

On Sat, 22 Aug 2009 16:25 -0500, "McSwain, Norman E Jr."
<nmcswai at tulane.edu> wrote:
> Not using c-collars on GSW of the neck has been the standard of care
> discussed for the last 3 years in the PHTLS training. Perhaps many EMT
> trainers or EMS medical directors have not been listening
>  

That is a huge problem in not just EMS. Teaching ACLS, there are all
sorts of myths taught as gospel, although they are not a part of the AHA
or ILCOR materials for the instructor. Or things are misrepresented,
where AHA states one thing, but the instructors interpret it in a very
narrow, very inaccurate way - and insist that this is the only
acceptable way. Then QA/QI/CYA departments start enforcing these fairy
tales.

Tim Noonan.

> Norman
>  
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

------------------------------

Message: 2
Date: Sat, 22 Aug 2009 16:55:39 -0500
From: "McSwain, Norman E Jr." <nmcswai at tulane.edu>
Subject: RE: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID:
    <B79C02DCC4FA074DB02381DF1C5D60BA01D2880E at EX07.ad.tulane.edu>
Content-Type: text/plain; charset="iso-8859-1"

Why is AHA and ACLS involved in trauma care? They are not the standard setters for this disease

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

From: trauma-list-bounces at trauma.org on behalf of htaed_rd at 123mail.org
Sent: Sat 8/22/2009 4:54 PM
To: Trauma-List [TRAUMA.ORG]
Subject: RE: C-SPINE CLEARANCE - surprise

On Sat, 22 Aug 2009 16:25 -0500, "McSwain, Norman E Jr."
<nmcswai at tulane.edu> wrote:
> Not using c-collars on GSW of the neck has been the standard of care
> discussed for the last 3 years in the PHTLS training. Perhaps many EMT
> trainers or EMS medical directors have not been listening
> 

That is a huge problem in not just EMS. Teaching ACLS, there are all
sorts of myths taught as gospel, although they are not a part of the AHA
or ILCOR materials for the instructor. Or things are misrepresented,
where AHA states one thing, but the instructors interpret it in a very
narrow, very inaccurate way - and insist that this is the only
acceptable way. Then QA/QI/CYA departments start enforcing these fairy
tales.

Tim Noonan.

> Norman
> 
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu>
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

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------------------------------

Message: 3
Date: Sun, 23 Aug 2009 08:03:50 +1000
From: Ian Seppelt <seppelt at med.usyd.edu.au>
Subject: Re: Preprocedure NPO in the ICU
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Cc: "trauma-list at trauma.org" <trauma-list at trauma.org>
Message-ID: <D68F87A5-7F16-4372-88D9-203102A146E9 at med.usyd.edu.au>
Content-Type: text/plain;   charset=us-ascii;   format=flowed;  delsp=yes

Irrational act - yes. Common - I hope not. Are you crazy? - I don't  
know you well enough!!!! A dumb thing to do - yes

Ian

On 23/08/2009, at 6:49 AM, cyberg66 at aol.com wrote:

>
> As I read this I think about the number of times I've seen ICU  
> nurses turn off the tube feeds in a sedated/intubated ICU patient  
> just because I laid the patient flat for an exam or CVL placement.  
> It always struck me as an irrational act that decreased the  
> patient's daily nutrition with no marginal gain in patient safety.  
> Is this a common practice? Am I crazy for thinking that's a dumb  
> thing to do?
>
>
>
>
>
>
>
> -----Original Message-----
> From: Ian Seppelt <seppelt at med.usyd.edu.au>
> To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>
> Cc: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>; Trauma-List  
> [TRAUMA.ORG] <trauma-list at trauma.org>
> Sent: Fri, Aug 21, 2009 10:08 pm
> Subject: Re: Preprocedure NPO in the ICU
>
>
>
>
>
>
>
>
>
> ?
>
>> We use a very similar protocol.  Patients are NOT starved before >  
>> surgery if there is a secure airway (ETT or trachy) unless there is  
>> > a surgical reason to starved (is emergency gut surgery). This is  
>> > particularly to avoid the prolonged starvation, that happens when  
>> a > 'booked urgent' case gets postponed. It makes no sense at all  
>> to > make intubated patients NBM (NPO). Talk to your anaesthetists.?
> ?
>
> Ian Seppelt, Sydney?
> ?
>
> ?
>
>> ?
>
>> On 21/08/2009, at 6:45 PM, "Dr Timothy Hardcastle" <dr.tchardcastle at absamail.co.za 
>> > > wrote:?
>
>> ?
>
>>> See blow:?
>
>>>> Might someone share their institutional policies regarding >>>  
>>>> preoperative?
>
>>>> NPO status constraints for ICU patients? In an attempt to maximize?
>
>>>> nutritional therapy in our critical care population I would >>>  
>>>> appreciate?
>
>>>> some supportive materials to provide to the anesthesia and  
>>>> endoscopy?
>
>>>> departments.?
>
>>>> ?
>
>>>> ?
>
>>>> ?
>
>>>> Thanks!?
>
>>>> ?
>
>>>> Cathy Dudick MD FACS?
>
>>>> ?
>
>>>> Harrah's Regional Trauma Center?
>
>>>> ?
>
>>>> Atlantic City NJ?
>
>>>> ?
>
>>>> --?
>
>>>> trauma-list : TRAUMA.ORG?
>
>>>> To change your settings or unsubscribe visit:?
>
>>>> http://www.trauma.org/index.php?/community/?
>
>>>> ?
>
>>> Hi Cathy?
>
>>> ?
>
>>> Based on our experience and the current nutrition / anaesthesia >>  
>>> literature?
>
>>> our policy is as follows:?
>
>>> ?
>
>>> For most of our patients feeding is into the stomach - NG tube. We  
>>> >> only?
>
>>> feed post-pyloric if not tolerated X3 attempts.?
>
>>> ?
>
>>> For non-airway or abdominal surgery (read head, chest, orthopaedic?
>
>>> procredures or radiology trips) feeding is NOT STOPPED at all in  
>>> >> patients?
>
>>> with an ETT or trachy in situ.?
>
>>> ?
>
>>> For open tracheostomy, feeding is stopped 4 hours prior to >>  
>>> procedure and?
>
>>> the tube is aspirated at the time of anaesthetic induction.  
>>> Feeding >> is?
>
>>> recommenced immediately on arrival back in our unit.?
>
>>> ?
>
>>> For abdominal surgery feeding is stopped also four hours prior to?
>
>>> procedure if definitive airway in place or 6 hours prior in >>  
>>> adults / 2?
>
>>> hours prior in children who will require airway manipulation.?
>
>>> ?
>
>>> TPN if running is not stopped unless the patient becomes unstable?
>
>>> intra-procedure.?
>
>>> ?
>
>>> There is evidence for all of this - mainly from the British and >>  
>>> German?
>
>>> literature.?
>
>>> ?
>
>>> Cheers?
>
>>> Tim?
>
>>> Dr T C Hardcastle?
>
>>> M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)?
>
>>> Principal Specialist Trauma Surgeon /?
>
>>> Honorary Lecturer University of KwaZulu-Natal Dept Surgery?
>
>>> Deputy Director - IALCH Trauma Service?
>
>>> Durban - South Africa?
>
>>> ?
>
>>> --?
>
>>> trauma-list : TRAUMA.ORG?
>
>>> To change your settings or unsubscribe visit:?
>
>>> http://www.trauma.org/index.php?/community/?
>
>> ?
>
>> --?
>
>> trauma-list : TRAUMA.ORG?
>
>> To change your settings or unsubscribe visit:?
>
>> http://www.trauma.org/index.php?/community/?
>
> --?
>
> trauma-list : TRAUMA.ORG?
>
> To change your settings or unsubscribe visit:?
>
> http://www.trauma.org/index.php?/community/?
>
>
>
>
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/

------------------------------

Message: 4
Date: Sat, 22 Aug 2009 20:27:16 -0600
From: "James Richardson" <jimmnn at comcast.net>
Subject: Vanishing in Midair, where's Trooper 2?
To: <coems at googlegroups.com>, <Paramedicine at yahoogroups.com>,
    <scan-dc at mailman.qth.net>
Cc: "'Trauma-List \[TRAUMA.ORG\]'" <trauma-list at trauma.org>,    "'EMED-L
    -- a list for Emergency Medicine practitioners.'"
    <EMED-L at LISTSRV.UCSF.EDU>, texasems-l at yahoogroups.com
Message-ID: <00e001ca2399$3cfa8560$b6ef9020$@net>
Content-Type: text/plain;   charset="us-ascii"

http://www.washingtonpost.com/wp-dyn/content/story/2009/08/22/ST200908220243
8.html

Jim<

------------------------------

Message: 5
Date: Sat, 22 Aug 2009 22:51:07 -0400
From: htaed_rd at 123mail.org
Subject: RE: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID: <1250995867.5176.1331150457 at webmail.messagingengine.com>
Content-Type: text/plain; charset="us-ascii"

On Sat, 22 Aug 2009 16:55 -0500, "McSwain, Norman E Jr."
<nmcswai at tulane.edu> wrote:
> Why is AHA and ACLS involved in trauma care? They are not the standard
> setters for this disease

I used the ACLS classes as an example of the way these alphabet courses
are taught badly. The topic being, why is so much misinformation passed
on, even though it is not part of the approved materials.

Since trauma occasionally affects the heart, the AHA does cover it. The
alternative would be silly. If you want to read what AHA teaches about
trauma you can find it at the link below. While the title is, "Part
10.7: Cardiac Arrest Associated With Trauma," they do not limit their
trauma teaching to cardiac arrest.  

http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-146

As you can see, the information is rather limited, but many more people
take ACLS courses than ATLS, PHTLS, and BTLS combined. While AHA may not
be the right people to set standards, we have to recognize that they may
have a significant effect on the treatment of trauma patients. As I
mentioned in the earlier post, what is taught may contradict AHA
guidelines, even if the AHA guidelines and the ACS guidelines agree.

Tim Noonan.

> Norman
>  
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 
> 
> ________________________________
> 
> From: trauma-list-bounces at trauma.org on behalf of htaed_rd at 123mail.org
> Sent: Sat 8/22/2009 4:54 PM
> To: Trauma-List [TRAUMA.ORG]
> Subject: RE: C-SPINE CLEARANCE - surprise
> 
> 
> 
> 
> 
> On Sat, 22 Aug 2009 16:25 -0500, "McSwain, Norman E Jr."
> <nmcswai at tulane.edu> wrote:
> > Not using c-collars on GSW of the neck has been the standard of care
> > discussed for the last 3 years in the PHTLS training. Perhaps many EMT
> > trainers or EMS medical directors have not been listening
> > 
> 
> That is a huge problem in not just EMS. Teaching ACLS, there are all
> sorts of myths taught as gospel, although they are not a part of the AHA
> or ILCOR materials for the instructor. Or things are misrepresented,
> where AHA states one thing, but the instructors interpret it in a very
> narrow, very inaccurate way - and insist that this is the only
> acceptable way. Then QA/QI/CYA departments start enforcing these fairy
> tales.
> 
> Tim Noonan.
> 
> 
> 
> > Norman
> > 
> > Norman McSwain MD
> > Trauma Director, Charity Hospital
> > Professor of Surgery, Tulane University
> > New Orleans LA
> > 504 988 5111
> > norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> 
> 

------------------------------

Message: 6
Date: Sat, 22 Aug 2009 23:38:03 -0400
From: Forrest Robleto <farcpr at gmail.com>
Subject: Re: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID:
    <2277979f0908222038x1352b157pa20a5cd3e4712ad6 at mail.gmail.com>
Content-Type: text/plain; charset=ISO-8859-1

DOT Standard Curriculum

V/R

Forrest Robleto, NCEE
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

Pablo Picasso<http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>
- "Computers are useless. They can only give you answers."

On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com> wrote:

> Standard EMT protocol where?  I didn't think that anything was standard in
> EMS
>
> Not protocol around here.
>
> LT
>
> -----Original Message-----
> From: Forrest Robleto <farcpr at gmail.com>
>
> Date: Sat, 22 Aug 2009 17:08:48
> To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org>
> Subject: Re: C-SPINE CLEARANCE - surprise
>
>
> Why is EMS putting  cervical collars on GSW patients?  Standard EMT
> protocol.
> Are we hurting more people than we are helping using cervical  collars?
> From
> all I've read
> Are we hurting more people than we are helping using cervical  collars? I
> hope not but I have no recourse.
>
>
> V/R
>
> Forrest Robleto, NCEE
> R House Health & Safety
> www.RHouseTraining.com <http://www.rhousetraining.com/>
> FRobleto at RhouseTraining.com
> 609-792-9047
>
>
>
>
> Marie von Ebner-Eschenbach<
> http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>
>  - "Even a stopped clock is right twice a day."
>
> On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:
>
> > clue
> >
> > Why is EMS putting  cervical collars on GSW patients?
> > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal
> cord
> > injury any form of a steroid or apply hypothermia
> > Are we hurting more people than we are helping using cervical  collars?
> > Are cervical collars in concept basically flawed
> >
> >
> >
> >
> > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,
> >  candymsnjd at aol.com writes:
> >
> >
> > K
> > can you give us a hint? is it that blue dye found in m and  m's?
> > but seriously, we are all waiting to learn the new information...hope
>  its
> > sooner than later
> >
> >
> >
> >
> >
> >
> >
> > -----Original  Message-----
> > From: KMATTOX at aol.com
> > To: trauma-list at trauma.org
> > Sent:  Sat, Aug 22, 2009 1:29 pm
> > Subject: Re: C-SPINE CLEARANCE -  surprise
> >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > Maybe,   I am  checking out the data, the research, the  publications.
> >
> > On at least 5 times in the past, suggestions of the data  that I have
> seen
> > has been a massive attack upon those who proposed  it and a running into
> > obscurity.
> >
> > As soon  as the information is solid and truly evidence based, I will
> share
> >
> > it.
> >
> > I do remember how much many on this list  tried to assassinate me when I
> > initially questioned MAST pants,  helicopter use for urban use,
> interosseus
> >
> > infusions, aggressive IV  solutions, hypotensive resuscitation, EC
> > thoracotomy,
> > CT vs arteriogram  for aortic injury, and many others.   I have deep
>  scars
> > to  prove it.
> >
> > k
> >
> >
> > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,
> > andrewj.bowman at gmail.com  writes:
> >
> > Wouldn't  it be better for us and the patients we care for  if you
> > shared the  information now?
> >
> > --
> > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> >  To change your settings or unsubscribe  visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> >
> >
> >
> > --
> > trauma-list  : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > To change your settings or unsubscribe  visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>

------------------------------

Message: 7
Date: Sat, 22 Aug 2009 23:06:57 -0500
From: Jules <jkaymdc at aim.com>
Subject: Re: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID:
    <f7c3cf0a0908222106m7913973es56ad31b3a75ea8bc at mail.gmail.com>
Content-Type: text/plain; charset=UTF-8

Which is no longer going to be followed with the adoption of the National
EMS Education Standards in 2010.

No longer a standard that I am aware of, and was pretty antiquated anyway. I
haven't seen it taught for years...

On Sat, Aug 22, 2009 at 10:38 PM, Forrest Robleto <farcpr at gmail.com> wrote:

> DOT Standard Curriculum
>
>
> V/R
>
> Forrest Robleto, NCEE
> R House Health & Safety
> www.RHouseTraining.com
> FRobleto at RhouseTraining.com
> 609-792-9047
>
>
>
>
> Pablo Picasso<
> http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>
> - "Computers are useless. They can only give you answers."
>
> On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com>
> wrote:
>
> > Standard EMT protocol where?  I didn't think that anything was standard
> in
> > EMS
> >
> > Not protocol around here.
> >
> > LT
> >
> > -----Original Message-----
> > From: Forrest Robleto <farcpr at gmail.com>
> >
> > Date: Sat, 22 Aug 2009 17:08:48
> > To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org
> >
> > Subject: Re: C-SPINE CLEARANCE - surprise
> >
> >
> > Why is EMS putting  cervical collars on GSW patients?  Standard EMT
> > protocol.
> > Are we hurting more people than we are helping using cervical  collars?
> > From
> > all I've read
> > Are we hurting more people than we are helping using cervical  collars? I
> > hope not but I have no recourse.
> >
> >
> > V/R
> >
> > Forrest Robleto, NCEE
> > R House Health & Safety
> > www.RHouseTraining.com <http://www.rhousetraining.com/>
> > FRobleto at RhouseTraining.com
> > 609-792-9047
> >
> >
> >
> >
> > Marie von Ebner-Eschenbach<
> >
> http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>
> >  - "Even a stopped clock is right twice a day."
> >
> > On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:
> >
> > > clue
> > >
> > > Why is EMS putting  cervical collars on GSW patients?
> > > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal
> > cord
> > > injury any form of a steroid or apply hypothermia
> > > Are we hurting more people than we are helping using cervical  collars?
> > > Are cervical collars in concept basically flawed
> > >
> > >
> > >
> > >
> > > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,
> > >  candymsnjd at aol.com writes:
> > >
> > >
> > > K
> > > can you give us a hint? is it that blue dye found in m and  m's?
> > > but seriously, we are all waiting to learn the new information...hope
> >  its
> > > sooner than later
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > -----Original  Message-----
> > > From: KMATTOX at aol.com
> > > To: trauma-list at trauma.org
> > > Sent:  Sat, Aug 22, 2009 1:29 pm
> > > Subject: Re: C-SPINE CLEARANCE -  surprise
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > Maybe,   I am  checking out the data, the research, the  publications.
> > >
> > > On at least 5 times in the past, suggestions of the data  that I have
> > seen
> > > has been a massive attack upon those who proposed  it and a running
> into
> > > obscurity.
> > >
> > > As soon  as the information is solid and truly evidence based, I will
> > share
> > >
> > > it.
> > >
> > > I do remember how much many on this list  tried to assassinate me when
> I
> > > initially questioned MAST pants,  helicopter use for urban use,
> > interosseus
> > >
> > > infusions, aggressive IV  solutions, hypotensive resuscitation, EC
> > > thoracotomy,
> > > CT vs arteriogram  for aortic injury, and many others.   I have deep
> >  scars
> > > to  prove it.
> > >
> > > k
> > >
> > >
> > > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,
> > > andrewj.bowman at gmail.com  writes:
> > >
> > > Wouldn't  it be better for us and the patients we care for  if you
> > > shared the  information now?
> > >
> > > --
> > > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > >  To change your settings or unsubscribe  visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > >
> > >
> > >
> > > --
> > > trauma-list  : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe  visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> >  > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/>
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/>
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>

------------------------------

Message: 8
Date: Sun, 23 Aug 2009 00:44:28 -0400
From: "Gustavo E. Flores" <gflores911 at gmail.com>
Subject: Re: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID: <4a90c92c.9553f10a.2779.3b8f at mx.google.com>
Content-Type: text/plain; charset=UTF-8

One of the fundamental problems of each one of today's guidelines, protocols, books, etc is the need to take into account the ways and means to keep it current in light of new evidence (even if it is conflicting or contrary).

Today's medical knowledgebase is too dynamic for any document to keep up with consistently. Many consensus guidelines have acknowledged this by setting up a schedule of periodic reviews (ILCOR being one of them).

Therefore, IMHO the validity of any institution is short-lived if not based on a prospective modus operandi.

OTOH, curriculums do not dictate standards of care. Curriculums dictate the common ground.?

Finally, all systems who fail to evolve must look at one internal culprit: the medical director.

Gustavo E. Flores, MD, EMT-P
gflores at emergencyteam.net
gflores911 at gmail.com

787-630-6301 (Puerto Rico)Jules wrote:

Which is no longer going to be followed with the adoption of the National

EMS Education Standards in 2010.

No longer a standard that I am aware of, and was pretty antiquated anyway. I

haven't seen it taught for years...

On Sat, Aug 22, 2009 at 10:38 PM, Forrest Robleto <farcpr at gmail.com> wrote:

> DOT Standard Curriculum

>

>

> V/R

>

> Forrest Robleto, NCEE

> R House Health & Safety

> www.RHouseTraining.com

> FRobleto at RhouseTraining.com

> 609-792-9047

>

>

>

>

> Pablo Picasso<

> http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>

> - "Computers are useless. They can only give you answers."

>

> On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com>

> wrote:

>

> > Standard EMT protocol where?  I didn't think that anything was standard

> in

> > EMS

> >

> > Not protocol around here.

> >

> > LT

> >

> > -----Original Message-----

> > From: Forrest Robleto <farcpr at gmail.com>

> >

> > Date: Sat, 22 Aug 2009 17:08:48

> > To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org

> >

> > Subject: Re: C-SPINE CLEARANCE - surprise

> >

> >

> > Why is EMS putting  cervical collars on GSW patients?  Standard EMT

> > protocol.

> > Are we hurting more people than we are helping using cervical  collars?

> > From

> > all I've read

> > Are we hurting more people than we are helping using cervical  collars? I

> > hope not but I have no recourse.

> >

> >

> > V/R

> >

> > Forrest Robleto, NCEE

> > R House Health & Safety

> > www.RHouseTraining.com <http://www.rhousetraining.com/>

> > FRobleto at RhouseTraining.com

> > 609-792-9047

> >

> >

> >

> >

> > Marie von Ebner-Eschenbach<

> >

> http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>

> >  - "Even a stopped clock is right twice a day."

> >

> > On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:

> >

> > > clue

> > >

> > > Why is EMS putting  cervical collars on GSW patients?

> > > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal

> > cord

> > > injury any form of a steroid or apply hypothermia

> > > Are we hurting more people than we are helping using cervical  collars?

> > > Are cervical collars in concept basically flawed

> > >

> > >

> > >

> > >

> > > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,

> > >  candymsnjd at aol.com writes:

> > >

> > >

> > > K

> > > can you give us a hint? is it that blue dye found in m and  m's?

> > > but seriously, we are all waiting to learn the new information...hope

> >  its

> > > sooner than later

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > -----Original  Message-----

> > > From: KMATTOX at aol.com

> > > To: trauma-list at trauma.org

> > > Sent:  Sat, Aug 22, 2009 1:29 pm

> > > Subject: Re: C-SPINE CLEARANCE -  surprise

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Maybe,   I am  checking out the data, the research, the  publications.

> > >

> > > On at least 5 times in the past, suggestions of the data  that I have

> > seen

> > > has been a massive attack upon those who proposed  it and a running

> into

> > > obscurity.

> > >

> > > As soon  as the information is solid and truly evidence based, I will

> > share

> > >

> > > it.

> > >

> > > I do remember how much many on this list  tried to assassinate me when

> I

> > > initially questioned MAST pants,  helicopter use for urban use,

> > interosseus

> > >

> > > infusions, aggressive IV  solutions, hypotensive resuscitation, EC

> > > thoracotomy,

> > > CT vs arteriogram  for aortic injury, and many others.   I have deep

> >  scars

> > > to  prove it.

> > >

> > > k

> > >

> > >

> > > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,

> > > andrewj.bowman at gmail.com  writes:

> > >

> > > Wouldn't  it be better for us and the patients we care for  if you

> > > shared the  information now?

> > >

> > > --

> > > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>

> > >  To change your settings or unsubscribe  visit:

> > > http://www.trauma.org/index.php?/community/

> > >

> > >

> > >

> > >

> > >

> > > --

> > > trauma-list  : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>

> > > To change your settings or unsubscribe  visit:

> > > http://www.trauma.org/index.php?/community/

> > >

> > >

> > > --

> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>

> >  > To change your settings or unsubscribe visit:

> > > http://www.trauma.org/index.php?/community/

> > >

> > --

> > trauma-list : TRAUMA.ORG <http://trauma.org/>

> > To change your settings or unsubscribe visit:

> > http://www.trauma.org/index.php?/community/

> > --

> > trauma-list : TRAUMA.ORG <http://trauma.org/>

> > To change your settings or unsubscribe visit:

> > http://www.trauma.org/index.php?/community/

> >

> --

> trauma-list : TRAUMA.ORG

> To change your settings or unsubscribe visit:

> http://www.trauma.org/index.php?/community/

>

--

trauma-list : TRAUMA.ORG

To change your settings or unsubscribe visit:

http://www.trauma.org/index.php?/community/

------------------------------

Message: 9
Date: Sat, 22 Aug 2009 23:51:24 -0500
From: "McSwain, Norman E Jr." <nmcswai at tulane.edu>
Subject: RE: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID:
    <B79C02DCC4FA074DB02381DF1C5D60BA01D2881C at EX07.ad.tulane.edu>
Content-Type: text/plain; charset="iso-8859-1"

unfortunately that is way out of date. too much foot dragging to get out a new one. ATLS, PHTLS and BTLS are the current standards for physicians and EMTs respectively

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

From: trauma-list-bounces at trauma.org on behalf of Forrest Robleto
Sent: Sat 8/22/2009 10:38 PM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: C-SPINE CLEARANCE - surprise

DOT Standard Curriculum

V/R

Forrest Robleto, NCEE
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

Pablo Picasso<http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>
- "Computers are useless. They can only give you answers."

On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com> wrote:

> Standard EMT protocol where?  I didn't think that anything was standard in
> EMS
>
> Not protocol around here.
>
> LT
>
> -----Original Message-----
> From: Forrest Robleto <farcpr at gmail.com>
>
> Date: Sat, 22 Aug 2009 17:08:48
> To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org>
> Subject: Re: C-SPINE CLEARANCE - surprise
>
>
> Why is EMS putting  cervical collars on GSW patients?  Standard EMT
> protocol.
> Are we hurting more people than we are helping using cervical  collars?
> From
> all I've read
> Are we hurting more people than we are helping using cervical  collars? I
> hope not but I have no recourse.
>
>
> V/R
>
> Forrest Robleto, NCEE
> R House Health & Safety
> www.RHouseTraining.com <http://www.rhousetraining.com/>
> FRobleto at RhouseTraining.com
> 609-792-9047
>
>
>
>
> Marie von Ebner-Eschenbach<
> http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>
>  - "Even a stopped clock is right twice a day."
>
> On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:
>
> > clue
> >
> > Why is EMS putting  cervical collars on GSW patients?
> > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal
> cord
> > injury any form of a steroid or apply hypothermia
> > Are we hurting more people than we are helping using cervical  collars?
> > Are cervical collars in concept basically flawed
> >
> >
> >
> >
> > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,
> >  candymsnjd at aol.com writes:
> >
> >
> > K
> > can you give us a hint? is it that blue dye found in m and  m's?
> > but seriously, we are all waiting to learn the new information...hope
>  its
> > sooner than later
> >
> >
> >
> >
> >
> >
> >
> > -----Original  Message-----
> > From: KMATTOX at aol.com
> > To: trauma-list at trauma.org
> > Sent:  Sat, Aug 22, 2009 1:29 pm
> > Subject: Re: C-SPINE CLEARANCE -  surprise
> >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > Maybe,   I am  checking out the data, the research, the  publications.
> >
> > On at least 5 times in the past, suggestions of the data  that I have
> seen
> > has been a massive attack upon those who proposed  it and a running into
> > obscurity.
> >
> > As soon  as the information is solid and truly evidence based, I will
> share
> >
> > it.
> >
> > I do remember how much many on this list  tried to assassinate me when I
> > initially questioned MAST pants,  helicopter use for urban use,
> interosseus
> >
> > infusions, aggressive IV  solutions, hypotensive resuscitation, EC
> > thoracotomy,
> > CT vs arteriogram  for aortic injury, and many others.   I have deep
>  scars
> > to  prove it.
> >
> > k
> >
> >
> > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,
> > andrewj.bowman at gmail.com  writes:
> >
> > Wouldn't  it be better for us and the patients we care for  if you
> > shared the  information now?
> >
> > --
> > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> >  To change your settings or unsubscribe  visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> >
> >
> >
> > --
> > trauma-list  : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > To change your settings or unsubscribe  visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

-------------- next part --------------
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------------------------------

Message: 10
Date: Sun, 23 Aug 2009 01:18:12 -0400
From: htaed_rd at 123mail.org
Subject: RE: C-SPINE CLEARANCE - surprise
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Message-ID: <1251004692.19983.1331159781 at webmail.messagingengine.com>
Content-Type: text/plain; charset="us-ascii"

And we have come full circle. Some people were shocked that these things
are still being taught. Somebody asked why these things continue to be
taught. Some answers were provided. This kind of response is exactly why
these will continue to be taught.

This is a problem. It does exist. Stating that what is being taught is
not the current standard may make you feel better, but it does nothing
to stop people from teaching nonsense. 

In other words, the lowest common denominator local instructor will
continue to set the guidelines in many places. Passing on whatever
mythology they happen to believe in.

The head of the local EMS organization that teaches PHTLS makes it quite
clear that spinal immobilization is the most important part of trauma
care, when he teaches. If you don't get the patient to look at you
straight out of the window of the car - "You just made him a quad! Game
over."

Tim Noonan.

On Sat, 22 Aug 2009 23:51 -0500, "McSwain, Norman E Jr."
<nmcswai at tulane.edu> wrote:
> unfortunately that is way out of date. too much foot dragging to get out
> a new one. ATLS, PHTLS and BTLS are the current standards for physicians
> and EMTs respectively
>  
> Norman
>  
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 
> 
> ________________________________
> 
> From: trauma-list-bounces at trauma.org on behalf of Forrest Robleto
> Sent: Sat 8/22/2009 10:38 PM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: C-SPINE CLEARANCE - surprise
> 
> 
> 
> DOT Standard Curriculum
> 
> 
> V/R
> 
> Forrest Robleto, NCEE
> R House Health & Safety
> www.RHouseTraining.com
> FRobleto at RhouseTraining.com
> 609-792-9047
> 
> 
> 
> 
> Pablo
> Picasso<http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>
> - "Computers are useless. They can only give you answers."
> 
> On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com>
> wrote:
> 
> > Standard EMT protocol where?  I didn't think that anything was standard in
> > EMS
> >
> > Not protocol around here.
> >
> > LT
> >
> > -----Original Message-----
> > From: Forrest Robleto <farcpr at gmail.com>
> >
> > Date: Sat, 22 Aug 2009 17:08:48
> > To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org>
> > Subject: Re: C-SPINE CLEARANCE - surprise
> >
> >
> > Why is EMS putting  cervical collars on GSW patients?  Standard EMT
> > protocol.
> > Are we hurting more people than we are helping using cervical  collars?
> > From
> > all I've read
> > Are we hurting more people than we are helping using cervical  collars? I
> > hope not but I have no recourse.
> >
> >
> > V/R
> >
> > Forrest Robleto, NCEE
> > R House Health & Safety
> > www.RHouseTraining.com <http://www.rhousetraining.com/>
> > FRobleto at RhouseTraining.com
> > 609-792-9047
> >
> >
> >
> >
> > Marie von Ebner-Eschenbach<
> > http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>
> >  - "Even a stopped clock is right twice a day."
> >
> > On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:
> >
> > > clue
> > >
> > > Why is EMS putting  cervical collars on GSW patients?
> > > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal
> > cord
> > > injury any form of a steroid or apply hypothermia
> > > Are we hurting more people than we are helping using cervical  collars?
> > > Are cervical collars in concept basically flawed
> > >
> > >
> > >
> > >
> > > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,
> > >  candymsnjd at aol.com writes:
> > >
> > >
> > > K
> > > can you give us a hint? is it that blue dye found in m and  m's?
> > > but seriously, we are all waiting to learn the new information...hope
> >  its
> > > sooner than later
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > -----Original  Message-----
> > > From: KMATTOX at aol.com
> > > To: trauma-list at trauma.org
> > > Sent:  Sat, Aug 22, 2009 1:29 pm
> > > Subject: Re: C-SPINE CLEARANCE -  surprise
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > Maybe,   I am  checking out the data, the research, the  publications.
> > >
> > > On at least 5 times in the past, suggestions of the data  that I have
> > seen
> > > has been a massive attack upon those who proposed  it and a running into
> > > obscurity.
> > >
> > > As soon  as the information is solid and truly evidence based, I will
> > share
> > >
> > > it.
> > >
> > > I do remember how much many on this list  tried to assassinate me when I
> > > initially questioned MAST pants,  helicopter use for urban use,
> > interosseus
> > >
> > > infusions, aggressive IV  solutions, hypotensive resuscitation, EC
> > > thoracotomy,
> > > CT vs arteriogram  for aortic injury, and many others.   I have deep
> >  scars
> > > to  prove it.
> > >
> > > k
> > >
> > >
> > > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,
> > > andrewj.bowman at gmail.com  writes:
> > >
> > > Wouldn't  it be better for us and the patients we care for  if you
> > > shared the  information now?
> > >
> > > --
> > > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > >  To change your settings or unsubscribe  visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > >
> > >
> > >
> > > --
> > > trauma-list  : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe  visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> >  > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/>
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/>
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> 
> 

------------------------------

Message: 11
Date: Sun, 23 Aug 2009 01:33:38 -0400
From: Scott Beaudoin <medic-sb at hotmail.com>
Subject: RE: C-SPINE CLEARANCE - surprise
To: <trauma-list at trauma.org>
Message-ID: <SNT101-W424725A2C9688C64882DA95FA0 at phx.gbl>
Content-Type: text/plain; charset="iso-8859-1"

It should be noted that Forrest is posting from the Country of New Jersey where the majority of EMTs do NOT function under a medical director and where the majority of BLS squads do NOT have treatment protocols and therefore rely only upon the DOT standard curriculum as a guide to treatment.
-Scott Beaudoin, MICP

Subject: RE: C-SPINE CLEARANCE - surprise
Date: Sat, 22 Aug 2009 23:51:24 -0500
From: nmcswai at tulane.edu
To: trauma-list at trauma.org

Re: C-SPINE CLEARANCE - surprise

unfortunately that is way out of date. too much foot dragging to get out a new one. ATLS, PHTLS and BTLS are the current standards for physicians and EMTs respectively

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu

From: trauma-list-bounces at trauma.org on behalf of Forrest Robleto
Sent: Sat 8/22/2009 10:38 PM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: C-SPINE CLEARANCE - surprise

DOT Standard Curriculum

V/R

Forrest Robleto, NCEE
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

Pablo Picasso<http://www.brainyquote.com/quotes/authors/p/pablo_picasso.html>
- "Computers are useless. They can only give you answers."

On Sat, Aug 22, 2009 at 5:22 PM, Larry Torrey <ltorrey at maine.rr.com> wrote:

> Standard EMT protocol where?  I didn't think that anything was standard in
> EMS
>
> Not protocol around here.
>
> LT
>
> -----Original Message-----
> From: Forrest Robleto <farcpr at gmail.com>
>
> Date: Sat, 22 Aug 2009 17:08:48
> To: Trauma-List [TRAUMA.ORG <http://trauma.org/>]<trauma-list at trauma.org>
> Subject: Re: C-SPINE CLEARANCE - surprise
>
>
> Why is EMS putting  cervical collars on GSW patients?  Standard EMT
> protocol.
> Are we hurting more people than we are helping using cervical  collars?
> From
> all I've read
> Are we hurting more people than we are helping using cervical  collars? I
> hope not but I have no recourse.
>
>
> V/R
>
> Forrest Robleto, NCEE
> R House Health & Safety
> www.RHouseTraining.com <http://www.rhousetraining.com/>
> FRobleto at RhouseTraining.com
> 609-792-9047
>
>
>
>
> Marie von Ebner-Eschenbach<
> http://www.brainyquote.com/quotes/authors/m/marie_von_ebnereschenbac.html>
>  - "Even a stopped clock is right twice a day."
>
> On Sat, Aug 22, 2009 at 4:38 PM, <KMATTOX at aol.com> wrote:
>
> > clue
> >
> > Why is EMS putting  cervical collars on GSW patients?
> > Why would ANYONE at ANYTIME and ANYWHERE give a patient with a spinal
> cord
> > injury any form of a steroid or apply hypothermia
> > Are we hurting more people than we are helping using cervical  collars?
> > Are cervical collars in concept basically flawed
> >
> >
> >
> >
> > In a message dated 8/22/2009 3:22:11 P.M. Central Daylight Time,
> >  candymsnjd at aol.com writes:
> >
> >
> > K
> > can you give us a hint? is it that blue dye found in m and  m's?
> > but seriously, we are all waiting to learn the new information...hope
>  its
> > sooner than later
> >
> >
> >
> >
> >
> >
> >
> > -----Original  Message-----
> > From: KMATTOX at aol.com
> > To: trauma-list at trauma.org
> > Sent:  Sat, Aug 22, 2009 1:29 pm
> > Subject: Re: C-SPINE CLEARANCE -  surprise
> >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > Maybe,   I am  checking out the data, the research, the  publications.
> >
> > On at least 5 times in the past, suggestions of the data  that I have
> seen
> > has been a massive attack upon those who proposed  it and a running into
> > obscurity.
> >
> > As soon  as the information is solid and truly evidence based, I will
> share
> >
> > it.
> >
> > I do remember how much many on this list  tried to assassinate me when I
> > initially questioned MAST pants,  helicopter use for urban use,
> interosseus
> >
> > infusions, aggressive IV  solutions, hypotensive resuscitation, EC
> > thoracotomy,
> > CT vs arteriogram  for aortic injury, and many others.   I have deep
>  scars
> > to  prove it.
> >
> > k
> >
> >
> > In a message dated 8/22/2009  12:12:53 P.M. Central Standard Time,
> > andrewj.bowman at gmail.com  writes:
> >
> > Wouldn't  it be better for us and the patients we care for  if you
> > shared the  information now?
> >
> > --
> > trauma-list :  TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> >  To change your settings or unsubscribe  visit:
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> >
> >
> >
> >
> >
> > --
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> >
> >
> > --
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> >
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------------------------------

Message: 12
Date: Sun, 23 Aug 2009 11:04:09 +0200
From: Christos Giannou <x.giannou at gmail.com>
Subject: Cx collar and GSW
To: trauma-list at trauma.org
Message-ID:
    <64c08ba00908230204n56b5b5fcpbfc86c6086fdbfc4 at mail.gmail.com>
Content-Type: text/plain; charset=ISO-8859-1

In addition to Micky's mention of the Barkana Y, Stein M, et al. article,
there was also a previous one: Arishita GI, Vayer JS, Bellamy RF. Cervical
spine immobilization of penetrating neck wounds in a hostile environment. J
Trauma 1989; 29: 332 - 337. and a subsequent one:Rhee P, Kuncir
EJ, Johnson L, Brown C, et al. Cervical spine injury is highly
dependent on the mechanism of injury following blunt and penetrating
assault. J Trauma 2006;
61: 1166-1170.

ICRC practice and teaching for years has been to understand the pathology
involved. The futility of a Cx collar for a GSW to the neck, or the mandible
or brain for that matter, is only too obvious whatever the status of
consciousness of the patient. This position is confirmed in our new War
Surgery book published earlier this year.

-- 
christos giannou
Monemvasia Lakonia
23070 Greece
tel & fax: (++30) 27320-61772
mob: (++30) 69 74 83 28 18

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