"The concept of spinal immobilization has been predicated entirely on philosophical, theoretical, and medicolegal grounds, and the justification for its use remains unchanged despite more than 4 decades of widespread use. Despite a lack of evidence clearly supporting spinal immobilization and an absence of documented cases of neurologic deterioration as a result of inadequate immobilization, and in the face of accumulating data challenging both the philosophical and theoretical grounds of immobilization, no randomized controlled trials have yet been performed in an attempt to validate its ongoing use or stratify any risk-benefit ratio. In the urban setting, the routine use of spinal immobilization likely adds little to improve the care of the injured patient, but correspondingly likely accounts for little harm to the patient (in the absence of penetrating trauma) or first responders. The financial harm to the system (if indeed there is little evidence to support routine use) is likely enormous, measured in both direct (expense of increasing the time and complexity of extrication as well as unnecessary tests and procedures) and indirect costs (inadvertently “validating” subsequent medicolegal claims of spine injury). Conversely, the routine use of spinal immobilization in the austere environment not only increases the financial cost of rescue operations, but also greatly increases the time, logistics, and complexity of the operation, thereby also exacting a cost in terms of increased morbidity and mortality to not only the patient but rescue personnel as well." wemjournal.org/article/S1080-6032(13)00071-9/fulltext
Posted on: Wed, 25 Sep 2013 05:52:42 +0000
Trending Topics
Recently Viewed Topics
© 2015