Abstract
Most emergency medicine systems (EMS) around the world
apply semi-rigid cervical collars as a routine to all injured patients
with a significant mechanism of injury. The science behind this
ritual is limited and the consequences may not always be
beneficial. The application of rigorous clinical trial methodology
in the prehospital setting is challenging but this should not prevent
an evidence base being developed.
There are many considerations that preclude good prehospital
research. These include ethical considerations, patient consent,
randomisation procedures and access to patient follow up
information. In addition the paramedic team already operates in
a time pressured environment and research procedures are rarely a
high priority in this setting. Against this backdrop, trials such as
Bernard et al.a??s1 where paramedic rapid sequence intubation in
patients with severe traumatic brain injury (TBI) was shown to
improve neurologic outcomes at 6 months compared with
intubation in the hospital are remarkable. It is possible to
challenge accepted dogma in the protocolised world of prehospital
care.
An
| Original language | English |
|---|---|
| Pages (from-to) | 841 - 842 |
| Number of pages | 2 |
| Journal | Injury Extra |
| Volume | 42 |
| Publication status | Published - 2011 |