Home Paramedicine/The Job "We Like To Use Interventions That Preserve Life"

"We Like To Use Interventions That Preserve Life"

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That quote from this press release,

FOR GUNSHOT AND STAB VICTIMS, ON-SCENE SPINE IMMOBILIZATION MAY DO MORE HARM THAN GOOD

gave me a chuckle.

Jan. 11, 2010- Immobilizing the spines of shooting and stabbing victims before they are taken to the hospital — standard procedure in Maryland and some other parts of the country — appears to double the risk of death compared to transporting patients to a trauma center without this time-consuming, on-scene medical intervention, according to a new study by Johns Hopkins researchers.

And the money quote,

If you’re twice as likely to die, that seems like a bad thing to do,” says Elliott R. Haut, M.D., an assistant professor of surgery at the Johns Hopkins University School of Medicine and the study leader. “We like to use interventions that preserve life.

I do have to question this quote though,

The researchers caution that spine immobilization has been shown to be well worth the time and quite effective in saving lives and reducing disability from injuries sustained in car crashes and similar events.

Friends of mine who have spent considerable amounts of time researching this separate topic, would disagree.

That aside, this study validates the idea that getting patients who sustained penetrating trauma to the hospital more quickly is beneficial while wasting time on scene with non essential treatments is bad for them. Which while not putting a time stamp on “The Golden Hour” reinforces the lesson that trauma is fixed in the Operating Room, not in the back of an ambulance.

I’m glad to report that my system abandoned the routine immobilization of patients with penetrating trauma several years ago.

Oh, I expect to read at least one comment along the lines of “My EMT instructor knew a guy who did a call with another EMT that told him that he heard from a nurse that there was this guy with a gun shot wound to elbow who wasn’t immobilized and that patient is now a quad.”

Because we all know that unsubstantiated anecdote is the way to practice.

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I'm a retired paramedic who formerly worked in a largish city in the Northeast corner of the U.S. In my post EMS life I provide Quality Improvement instruction and consulting under contract. I haven't really retired, I just don't work nights, holidays, or weekends.  I escaped the Northeast a couple of years ago and now live in Texas.  I'm more than just a little opinionated, but that comes with having been around the block more than once. You can email me at EMSArtifact@gmail.com After living most of my life (so far) in the northeast my lovely wife and I have moved to central Texas because we weren't comfortable in the northeast any longer. Life is full of twists and turns.

4 COMMENTS

  1. The only reason I like to board a gunshot or stab victim is more about they are easier to move onto the the stretcher or from the stretcher to the ED bed. I agree with not taking the time to do a c-collar and such but slipping them on a board real quick and strapping them down real quick.

  2. "Oh, I expect to read at least one comment along the lines of "My EMT instructor knew a guy who did a call with another EMT…there was this guy with a gun shot wound to elbow who wasn't immobilized and that patient is now a quad."And now, the REST of the story. He was shot in the elbow, lost his balance, and fell off the roof to the street below. Four stories below.Yeah…I hear those stories too…

  3. 9-Echo-1, I actually had a guy that was shot while being chased across the roof of a project building. He went to jump from one building to the next only there was no "next" building. He did fall four stories to the street, but he didn't survive so we didn't bother boarding him. Really, me, not some friend's friend's ex partner. The call came in as a pedestrian struck!

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