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Norwegian LTP Video

Doc Holiday drydok at hotmail.com
Wed Oct 12 16:54:55 BST 2016

From: trauma-list-bounces at trauma.org <trauma-list-bounces at trauma.org> on behalf of Jel Coward <jel at wildmedic.org>

> I am not sure that I follow the argument that 'even if current practice is not evidence based, we shouldn't change it unless we have evidence for that change'.

--> That's not the argument.

It goes more like we shouldn't change unless we have the evidence that is sensible/possible/feasible to obtain. We won't insist on evidence where it is not sensible.

And, if you look at it another way. If you are changing without evidence, you're not really changing anything. You'd still be doing "one of the things for which there is no evidence", just as you have before you "changed". I.e. the way we look at the science of our practice today is that "change" is not merely moving from "something" to "another thing", but moving from a status of less evidence to that of more...

And evidence does not have to be a "study", but if a study is so possible to do, why not do it? We have a country in which it is acceptable to "do it sideways", so we have the ideal set-up to run a study comparing outcomes between that and the supine method and demonstrate whether the effort of re-education & re-training around the world would be of benefit before it's undertaken.

We'll be able to establish whether there is a sufficient number of cases in which airway is of such concern that the position is indicated, but a more formal airway protection (which would eliminate the indication) will be used. Such patients, in my current experience, are not frequent - they tend to get some airway protection inserted and I doubt that the urge to do that will be dissipated by the lateral position... But what do I know - maybe such cases do exist and this study will document them and we'll find that there is no issue with pelvic, limb and rib fractures (see my previous posting).

I think we need a study for this to catch on...

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