Are current cervical collars doing more harm than good? New studies...

[Guest guest]

Well I have something for the group. Current cadaver studies and a presentation

made by Dr. Persse, Medical Director for Houston EMS, at February's Gathering of

Eagles, show that current cervical collars that we use in prehospital and

hospital are probably causing more harm than good. By pulling traction and

realigning the cervical spine to apply current c-collars, we are causing

internal decapitation. He posed the question that when presented with a

fractured arm, we are to splint it in the position found; so why wouldn't we do

that with the cervical spine when it involves the spinal cord? Another study

suggested that in the case of penetrating trauma, we are spending too much time

on-scene packaging them up with our spinal immobilization techniques which

increases mortality rates. Dr. Ray Fowler states that " we should be splinting

the cervical spine " with some type of cervical splint.

I found a " cervical splint " and encourage you to watch it at:

I encourage your discussion, comments, and feelings of this current study

findings and how we may correct the harm that may be occuring.

[Guest guest]

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

[Guest guest]

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

[Guest guest]

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

[Guest guest]

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that,

just like anybody can put the KED on a student model at the NREMT exam. Real

life is different. I want to see how they put it on a guy who crashed his

crotch rocket and is lying in the ditch without moving the C-spine. I want to

see them apply it when the patient's got 4 layers of clothing on including a

leather Harley jacket. I want outcome studies that show a significant

improvement in survival as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that,

just like anybody can put the KED on a student model at the NREMT exam. Real

life is different. I want to see how they put it on a guy who crashed his

crotch rocket and is lying in the ditch without moving the C-spine. I want to

see them apply it when the patient's got 4 layers of clothing on including a

leather Harley jacket. I want outcome studies that show a significant

improvement in survival as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Preach on man....preach on. These guys were at the Eagles and paid us a visit

shortly thereafter. They have a couple of interesting tools, but nothing to

show that they work other than videos and such. A large number of EMS personnel

cannot " properly " apply the cervical collars we use today and the majority of

those are a single push button and a velcro strap....with this thing and all the

parts that flip, flop, tab a into slot b, etc....I would rather use towels and

sheets, tape the head in the position found and get my patient off the scene and

to the trauma center so that definitive care can be given for the patient.

Speaking of tape...if holding the patient's head still is our goal...why do we

pinch the tape over the forehead and not stick it to the skin? Maybe we are

concerned that they may be a paraplegic but at least they will still have

eyebrows?

Dudley

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Preach on man....preach on. These guys were at the Eagles and paid us a visit

shortly thereafter. They have a couple of interesting tools, but nothing to

show that they work other than videos and such. A large number of EMS personnel

cannot " properly " apply the cervical collars we use today and the majority of

those are a single push button and a velcro strap....with this thing and all the

parts that flip, flop, tab a into slot b, etc....I would rather use towels and

sheets, tape the head in the position found and get my patient off the scene and

to the trauma center so that definitive care can be given for the patient.

Speaking of tape...if holding the patient's head still is our goal...why do we

pinch the tape over the forehead and not stick it to the skin? Maybe we are

concerned that they may be a paraplegic but at least they will still have

eyebrows?

Dudley

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Ha! Yes. We pinch the tape over the forehead so that even if they're rendered

a quadriplegic their eyebrows will still be intact. It's all cosmetic, but

then, that's what we're all about. Cosmetics.

How many toys have we fallen for? I remember the Jaw Screw! It looked like a

midieval torture device, Never used it, but we carried it. Next were MAST.

The newest thing. Got to have them. State required them. Cause an

autotransfusion from the legs to the body core. Not. Doesn't happen. KED.

Must have this toy. Except that it was designed by its inventor for something

other than EMS use. Hare Traction Splint. Designed by a former cop who started

a company, DynaMed, that sold lots of dreck to medics who didn't know any better

than to buy it. No research to support its use. Glenn Hare was a good guy, but

he didn't understand research. The Philadelphia Collar, then the rest of them

that tried to figure out differences between them and the Philly so they could

patent the devices. Massive advertising campaigns. All pretty lame. No proven

advantages from any of them. No proven advantage for any sort of spinal

immobilization. But we love toys. When we apply one of these toys in the

field, we get instant gratification. We think we have done something really

great! Sorry. Most of what we do is bulls**t and has no effect on patient

outcomes. We can apply all sorts of toys as long as we do it ENROUTE to the

hospital. That will make us feel good, and maybe it will help, but if our

patient needs an application of cold steel, there's no evidence that anything we

do in the field makes a bit if difference.

So some will buy the Whatzit C-Spine Device and their medics will struggle to

apply it, spending lots of time that would be better spent on the road to the

appropriate hospital.

No benefits will result, but also no data will be generated, so we'll all still

tout our prejudices.

GG

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Ha! Yes. We pinch the tape over the forehead so that even if they're rendered

a quadriplegic their eyebrows will still be intact. It's all cosmetic, but

then, that's what we're all about. Cosmetics.

How many toys have we fallen for? I remember the Jaw Screw! It looked like a

midieval torture device, Never used it, but we carried it. Next were MAST.

The newest thing. Got to have them. State required them. Cause an

autotransfusion from the legs to the body core. Not. Doesn't happen. KED.

Must have this toy. Except that it was designed by its inventor for something

other than EMS use. Hare Traction Splint. Designed by a former cop who started

a company, DynaMed, that sold lots of dreck to medics who didn't know any better

than to buy it. No research to support its use. Glenn Hare was a good guy, but

he didn't understand research. The Philadelphia Collar, then the rest of them

that tried to figure out differences between them and the Philly so they could

patent the devices. Massive advertising campaigns. All pretty lame. No proven

advantages from any of them. No proven advantage for any sort of spinal

immobilization. But we love toys. When we apply one of these toys in the

field, we get instant gratification. We think we have done something really

great! Sorry. Most of what we do is bulls**t and has no effect on patient

outcomes. We can apply all sorts of toys as long as we do it ENROUTE to the

hospital. That will make us feel good, and maybe it will help, but if our

patient needs an application of cold steel, there's no evidence that anything we

do in the field makes a bit if difference.

So some will buy the Whatzit C-Spine Device and their medics will struggle to

apply it, spending lots of time that would be better spent on the road to the

appropriate hospital.

No benefits will result, but also no data will be generated, so we'll all still

tout our prejudices.

GG

Re: Are current cervical collars doing more harm than

good? New studies...

>>> Dr. Ray Fowler states that " we should be splinting the cervical spine " with

some type of cervical splint. <<<

So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

G

Dr. Fowler says a lot of things.

Kenny Navarro

Dallas

=

[Guest guest]

Answer: Don't pinch the tape. Apply it directly over the eyebrows.

When it is time to remove it, tear it between the eyes, and peel

outward. Eyebrows stay in place.

Or, if they really pissed you off, peel toward one side, which leaves

one eyebrow in place and removes the other.

>

>

> Preach on man....preach on. These guys were at the Eagles and paid us

> a visit shortly thereafter. They have a couple of interesting tools,

> but nothing to show that they work other than videos and such. A large

> number of EMS personnel cannot " properly " apply the cervical collars

> we use today and the majority of those are a single push button and a

> velcro strap....with this thing and all the parts that flip, flop, tab

> a into slot b, etc....I would rather use towels and sheets, tape the

> head in the position found and get my patient off the scene and to the

> trauma center so that definitive care can be given for the patient.

>

> Speaking of tape...if holding the patient's head still is our

> goal...why do we pinch the tape over the forehead and not stick it to

> the skin? Maybe we are concerned that they may be a paraplegic but at

> least they will still have eyebrows?

>

> Dudley

>

> Re: Are current cervical collars doing more harm

> than good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical

> spine " with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-spineboard

> attached? Where's the literature to support that device over any

> other? Does he have an interest in the device?

> It's not clear to me how one can apply that thing to a supine patient

> without some manipulation of the C-spine and back. The video thing

> shows it being applied to a conscious, upright-sitting model. Swell.

> Anybody can do that, just like anybody can put the KED on a student

> model at the NREMT exam. Real life is different. I want to see how

> they put it on a guy who crashed his crotch rocket and is lying in the

> ditch without moving the C-spine. I want to see them apply it when the

> patient's got 4 layers of clothing on including a leather Harley

> jacket. I want outcome studies that show a significant improvement in

> survival as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do)

> once again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

Answer: Don't pinch the tape. Apply it directly over the eyebrows.

When it is time to remove it, tear it between the eyes, and peel

outward. Eyebrows stay in place.

Or, if they really pissed you off, peel toward one side, which leaves

one eyebrow in place and removes the other.

>

>

> Preach on man....preach on. These guys were at the Eagles and paid us

> a visit shortly thereafter. They have a couple of interesting tools,

> but nothing to show that they work other than videos and such. A large

> number of EMS personnel cannot " properly " apply the cervical collars

> we use today and the majority of those are a single push button and a

> velcro strap....with this thing and all the parts that flip, flop, tab

> a into slot b, etc....I would rather use towels and sheets, tape the

> head in the position found and get my patient off the scene and to the

> trauma center so that definitive care can be given for the patient.

>

> Speaking of tape...if holding the patient's head still is our

> goal...why do we pinch the tape over the forehead and not stick it to

> the skin? Maybe we are concerned that they may be a paraplegic but at

> least they will still have eyebrows?

>

> Dudley

>

> Re: Are current cervical collars doing more harm

> than good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical

> spine " with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-spineboard

> attached? Where's the literature to support that device over any

> other? Does he have an interest in the device?

> It's not clear to me how one can apply that thing to a supine patient

> without some manipulation of the C-spine and back. The video thing

> shows it being applied to a conscious, upright-sitting model. Swell.

> Anybody can do that, just like anybody can put the KED on a student

> model at the NREMT exam. Real life is different. I want to see how

> they put it on a guy who crashed his crotch rocket and is lying in the

> ditch without moving the C-spine. I want to see them apply it when the

> patient's got 4 layers of clothing on including a leather Harley

> jacket. I want outcome studies that show a significant improvement in

> survival as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do)

> once again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

No Gene, Fowler is agreeing with Persse; not disagreeing. All of the studies

that Dr. Persse stated in his presentation supported his statement. Fowler

agrees with him and his statement that I quoted him was to me over lunch. And

yes Kenny Fowler states a lot of things however he is agreeing with Persse and

the other medical directors of the Eagles.

The literature on this new device... go to their site like I did and look at it.

I personally had it applied to me while I was laying down with a coat on and it

didn't move me anymore than applying a regular c-collar. The video shows

applying it with one person you still follow all current protocols by holding

the head in " position found " . We did a field trial on it at MedStar in Ft Worth

3 years ago and the statement was made that " this thing is ahead of its time

because it does something that we are doing right now. It is actually spliting

the spine. " Now with the current studies, splinting the spine is what we

probably should be doing. If we have a broken arm, we splint it in

place...right? So why wouldn't we splint a fractured SPINE in place when it

involves the spine. My point is now that it has been questioned that current

methods may be causing harm, what are we going to do now? Are we just going to

keep doing the same thing because that is just what we do? Or are we going

to...OMG here it comes...CHANGE?

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more harm than

good? New studies...

>

>

>

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical spine "

with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

> It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that,

just like anybody can put the KED on a student model at the NREMT exam. Real

life is different. I want to see how they put it on a guy who crashed his

crotch rocket and is lying in the ditch without moving the C-spine. I want to

see them apply it when the patient's got 4 layers of clothing on including a

leather Harley jacket. I want outcome studies that show a significant

improvement in survival as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

> G

>

>

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

>

>

>

>

>

>

> =

>

>

>

[Guest guest]

No Gene, Fowler is agreeing with Persse; not disagreeing. All of the studies

that Dr. Persse stated in his presentation supported his statement. Fowler

agrees with him and his statement that I quoted him was to me over lunch. And

yes Kenny Fowler states a lot of things however he is agreeing with Persse and

the other medical directors of the Eagles.

The literature on this new device... go to their site like I did and look at it.

I personally had it applied to me while I was laying down with a coat on and it

didn't move me anymore than applying a regular c-collar. The video shows

applying it with one person you still follow all current protocols by holding

the head in " position found " . We did a field trial on it at MedStar in Ft Worth

3 years ago and the statement was made that " this thing is ahead of its time

because it does something that we are doing right now. It is actually spliting

the spine. " Now with the current studies, splinting the spine is what we

probably should be doing. If we have a broken arm, we splint it in

place...right? So why wouldn't we splint a fractured SPINE in place when it

involves the spine. My point is now that it has been questioned that current

methods may be causing harm, what are we going to do now? Are we just going to

keep doing the same thing because that is just what we do? Or are we going

to...OMG here it comes...CHANGE?

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more harm than

good? New studies...

>

>

>

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical spine "

with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

> It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that,

just like anybody can put the KED on a student model at the NREMT exam. Real

life is different. I want to see how they put it on a guy who crashed his

crotch rocket and is lying in the ditch without moving the C-spine. I want to

see them apply it when the patient's got 4 layers of clothing on including a

leather Harley jacket. I want outcome studies that show a significant

improvement in survival as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

> G

>

>

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

>

>

>

>

>

>

> =

>

>

>

[Guest guest]

Yes I agree with your point Gene, anything that increases scene time which

increases the time to definative care in trauma (expecially after the

penetrating trauma study and conclusion) is not beneficial to the patient

outcome. Whatever we utilyze must not increase scene times, our treatments

should be enroute, getting the patient to a hard table and a cold steel knife.

We should not just use a " new toy " and science should direct what we use. The

sad thing is that I remember all of these toys you mention...I hate showing my

age!

Another device that Dr. Persse commented on is some type of EMS " Halo " . Has

anybody seen or heard about that? Again, is it another " toy " ? There has to be

an answer because based on the presented studies, I do feel that what we are

currently doing may be doing harm. Thanks for your discussion. I still

encourage more.

Jon

>

> Ha! Yes. We pinch the tape over the forehead so that even if they're

rendered a quadriplegic their eyebrows will still be intact. It's all cosmetic,

but then, that's what we're all about. Cosmetics.

>

>

> How many toys have we fallen for? I remember the Jaw Screw! It looked like a

midieval torture device, Never used it, but we carried it. Next were MAST.

The newest thing. Got to have them. State required them. Cause an

autotransfusion from the legs to the body core. Not. Doesn't happen. KED.

Must have this toy. Except that it was designed by its inventor for something

other than EMS use. Hare Traction Splint. Designed by a former cop who started

a company, DynaMed, that sold lots of dreck to medics who didn't know any better

than to buy it. No research to support its use. Glenn Hare was a good guy, but

he didn't understand research. The Philadelphia Collar, then the rest of them

that tried to figure out differences between them and the Philly so they could

patent the devices. Massive advertising campaigns. All pretty lame. No proven

advantages from any of them. No proven advantage for any sort of spinal

immobilization. But we love toys. When we apply one of these toys in the

field, we get instant gratification. We think we have done something really

great! Sorry. Most of what we do is bulls**t and has no effect on patient

outcomes. We can apply all sorts of toys as long as we do it ENROUTE to the

hospital. That will make us feel good, and maybe it will help, but if our

patient needs an application of cold steel, there's no evidence that anything we

do in the field makes a bit if difference.

>

>

> So some will buy the Whatzit C-Spine Device and their medics will struggle to

apply it, spending lots of time that would be better spent on the road to the

appropriate hospital.

>

>

> No benefits will result, but also no data will be generated, so we'll all

still tout our prejudices.

>

>

> GG

>

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more harm than

good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical spine "

with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

> It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

Yes I agree with your point Gene, anything that increases scene time which

increases the time to definative care in trauma (expecially after the

penetrating trauma study and conclusion) is not beneficial to the patient

outcome. Whatever we utilyze must not increase scene times, our treatments

should be enroute, getting the patient to a hard table and a cold steel knife.

We should not just use a " new toy " and science should direct what we use. The

sad thing is that I remember all of these toys you mention...I hate showing my

age!

Another device that Dr. Persse commented on is some type of EMS " Halo " . Has

anybody seen or heard about that? Again, is it another " toy " ? There has to be

an answer because based on the presented studies, I do feel that what we are

currently doing may be doing harm. Thanks for your discussion. I still

encourage more.

Jon

>

> Ha! Yes. We pinch the tape over the forehead so that even if they're

rendered a quadriplegic their eyebrows will still be intact. It's all cosmetic,

but then, that's what we're all about. Cosmetics.

>

>

> How many toys have we fallen for? I remember the Jaw Screw! It looked like a

midieval torture device, Never used it, but we carried it. Next were MAST.

The newest thing. Got to have them. State required them. Cause an

autotransfusion from the legs to the body core. Not. Doesn't happen. KED.

Must have this toy. Except that it was designed by its inventor for something

other than EMS use. Hare Traction Splint. Designed by a former cop who started

a company, DynaMed, that sold lots of dreck to medics who didn't know any better

than to buy it. No research to support its use. Glenn Hare was a good guy, but

he didn't understand research. The Philadelphia Collar, then the rest of them

that tried to figure out differences between them and the Philly so they could

patent the devices. Massive advertising campaigns. All pretty lame. No proven

advantages from any of them. No proven advantage for any sort of spinal

immobilization. But we love toys. When we apply one of these toys in the

field, we get instant gratification. We think we have done something really

great! Sorry. Most of what we do is bulls**t and has no effect on patient

outcomes. We can apply all sorts of toys as long as we do it ENROUTE to the

hospital. That will make us feel good, and maybe it will help, but if our

patient needs an application of cold steel, there's no evidence that anything we

do in the field makes a bit if difference.

>

>

> So some will buy the Whatzit C-Spine Device and their medics will struggle to

apply it, spending lots of time that would be better spent on the road to the

appropriate hospital.

>

>

> No benefits will result, but also no data will be generated, so we'll all

still tout our prejudices.

>

>

> GG

>

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more harm than

good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical spine "

with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to support his

assertion? Where's the beef? Where's the evidence? Is he touting the latest

model C-collar that has the little mini-spineboard attached? Where's the

literature to support that device over any other? Does he have an interest in

the device?

> It's not clear to me how one can apply that thing to a supine patient without

some manipulation of the C-spine and back. The video thing shows it being

applied to a conscious, upright-sitting model. Swell. Anybody can do that, just

like anybody can put the KED on a student model at the NREMT exam. Real life is

different. I want to see how they put it on a guy who crashed his crotch rocket

and is lying in the ditch without moving the C-spine. I want to see them apply

it when the patient's got 4 layers of clothing on including a leather Harley

jacket. I want outcome studies that show a significant improvement in survival

as a result of use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I do) once

again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

That presentation (by Dr. Persse) is available for downloading here:

http://gatheringofeagles.us/2010/Presentations/Presentations2010.html

>>> On Wed, Mar 31, 2010 at 11:42 AM, in message

hovu1n+tru2 (AT) eGroups (DOT) com>, " Jon " jon@...> wrote:

Yes I agree with your point Gene, anything that increases scene time

which increases the time to definative care in trauma (expecially after

the penetrating trauma study and conclusion) is not beneficial to the

patient outcome. Whatever we utilyze must not increase scene times, our

treatments should be enroute, getting the patient to a hard table and a

cold steel knife. We should not just use a " new toy " and science should

direct what we use. The sad thing is that I remember all of these toys

you mention...I hate showing my age!

Another device that Dr. Persse commented on is some type of EMS " Halo " .

Has anybody seen or heard about that? Again, is it another " toy " ? There

has to be an answer because based on the presented studies, I do feel

that what we are currently doing may be doing harm. Thanks for your

discussion. I still encourage more.

Jon

>

> Ha! Yes. We pinch the tape over the forehead so that even if they're

rendered a quadriplegic their eyebrows will still be intact. It's all

cosmetic, but then, that's what we're all about. Cosmetics.

>

>

> How many toys have we fallen for? I remember the Jaw Screw! It looked

like a midieval torture device, Never used it, but we carried it. Next

were MAST. The newest thing. Got to have them. State required them.

Cause an autotransfusion from the legs to the body core. Not. Doesn't

happen. KED. Must have this toy. Except that it was designed by its

inventor for something other than EMS use. Hare Traction Splint.

Designed by a former cop who started a company, DynaMed, that sold lots

of dreck to medics who didn't know any better than to buy it. No

research to support its use. Glenn Hare was a good guy, but he didn't

understand research. The Philadelphia Collar, then the rest of them that

tried to figure out differences between them and the Philly so they

could patent the devices. Massive advertising campaigns. All pretty

lame. No proven advantages from any of them. No proven advantage for any

sort of spinal immobilization. But we love toys. When we apply one of

these toys in the field, we get instant gratification. We think we have

done something really great! Sorry. Most of what we do is bulls**t and

has no effect on patient outcomes. We can apply all sorts of toys as

long as we do it ENROUTE to the hospital. That will make us feel good,

and maybe it will help, but if our patient needs an application of cold

steel, there's no evidence that anything we do in the field makes a bit

if difference.

>

>

> So some will buy the Whatzit C-Spine Device and their medics will

struggle to apply it, spending lots of time that would be better spent

on the road to the appropriate hospital.

>

>

> No benefits will result, but also no data will be generated, so we'll

all still tout our prejudices.

>

>

> GG

>

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more

harm than good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical

spine " with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to

support his assertion? Where's the beef? Where's the evidence? Is he

touting the latest model C-collar that has the little mini-spineboard

attached? Where's the literature to support that device over any other?

Does he have an interest in the device?

> It's not clear to me how one can apply that thing to a supine patient

without some manipulation of the C-spine and back. The video thing shows

it being applied to a conscious, upright-sitting model. Swell. Anybody

can do that, just like anybody can put the KED on a student model at the

NREMT exam. Real life is different. I want to see how they put it on a

guy who crashed his crotch rocket and is lying in the ditch without

moving the C-spine. I want to see them apply it when the patient's got 4

layers of clothing on including a leather Harley jacket. I want outcome

studies that show a significant improvement in survival as a result of

use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I

do) once again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

That presentation (by Dr. Persse) is available for downloading here:

http://gatheringofeagles.us/2010/Presentations/Presentations2010.html

>>> On Wed, Mar 31, 2010 at 11:42 AM, in message

hovu1n+tru2 (AT) eGroups (DOT) com>, " Jon " jon@...> wrote:

Yes I agree with your point Gene, anything that increases scene time

which increases the time to definative care in trauma (expecially after

the penetrating trauma study and conclusion) is not beneficial to the

patient outcome. Whatever we utilyze must not increase scene times, our

treatments should be enroute, getting the patient to a hard table and a

cold steel knife. We should not just use a " new toy " and science should

direct what we use. The sad thing is that I remember all of these toys

you mention...I hate showing my age!

Another device that Dr. Persse commented on is some type of EMS " Halo " .

Has anybody seen or heard about that? Again, is it another " toy " ? There

has to be an answer because based on the presented studies, I do feel

that what we are currently doing may be doing harm. Thanks for your

discussion. I still encourage more.

Jon

>

> Ha! Yes. We pinch the tape over the forehead so that even if they're

rendered a quadriplegic their eyebrows will still be intact. It's all

cosmetic, but then, that's what we're all about. Cosmetics.

>

>

> How many toys have we fallen for? I remember the Jaw Screw! It looked

like a midieval torture device, Never used it, but we carried it. Next

were MAST. The newest thing. Got to have them. State required them.

Cause an autotransfusion from the legs to the body core. Not. Doesn't

happen. KED. Must have this toy. Except that it was designed by its

inventor for something other than EMS use. Hare Traction Splint.

Designed by a former cop who started a company, DynaMed, that sold lots

of dreck to medics who didn't know any better than to buy it. No

research to support its use. Glenn Hare was a good guy, but he didn't

understand research. The Philadelphia Collar, then the rest of them that

tried to figure out differences between them and the Philly so they

could patent the devices. Massive advertising campaigns. All pretty

lame. No proven advantages from any of them. No proven advantage for any

sort of spinal immobilization. But we love toys. When we apply one of

these toys in the field, we get instant gratification. We think we have

done something really great! Sorry. Most of what we do is bulls**t and

has no effect on patient outcomes. We can apply all sorts of toys as

long as we do it ENROUTE to the hospital. That will make us feel good,

and maybe it will help, but if our patient needs an application of cold

steel, there's no evidence that anything we do in the field makes a bit

if difference.

>

>

> So some will buy the Whatzit C-Spine Device and their medics will

struggle to apply it, spending lots of time that would be better spent

on the road to the appropriate hospital.

>

>

> No benefits will result, but also no data will be generated, so we'll

all still tout our prejudices.

>

>

> GG

>

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more

harm than good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical

spine " with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to

support his assertion? Where's the beef? Where's the evidence? Is he

touting the latest model C-collar that has the little mini-spineboard

attached? Where's the literature to support that device over any other?

Does he have an interest in the device?

> It's not clear to me how one can apply that thing to a supine patient

without some manipulation of the C-spine and back. The video thing shows

it being applied to a conscious, upright-sitting model. Swell. Anybody

can do that, just like anybody can put the KED on a student model at the

NREMT exam. Real life is different. I want to see how they put it on a

guy who crashed his crotch rocket and is lying in the ditch without

moving the C-spine. I want to see them apply it when the patient's got 4

layers of clothing on including a leather Harley jacket. I want outcome

studies that show a significant improvement in survival as a result of

use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I

do) once again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

That presentation (by Dr. Persse) is available for downloading here:

http://gatheringofeagles.us/2010/Presentations/Presentations2010.html

>>> On Wed, Mar 31, 2010 at 11:42 AM, in message

hovu1n+tru2 (AT) eGroups (DOT) com>, " Jon " jon@...> wrote:

Yes I agree with your point Gene, anything that increases scene time

which increases the time to definative care in trauma (expecially after

the penetrating trauma study and conclusion) is not beneficial to the

patient outcome. Whatever we utilyze must not increase scene times, our

treatments should be enroute, getting the patient to a hard table and a

cold steel knife. We should not just use a " new toy " and science should

direct what we use. The sad thing is that I remember all of these toys

you mention...I hate showing my age!

Another device that Dr. Persse commented on is some type of EMS " Halo " .

Has anybody seen or heard about that? Again, is it another " toy " ? There

has to be an answer because based on the presented studies, I do feel

that what we are currently doing may be doing harm. Thanks for your

discussion. I still encourage more.

Jon

>

> Ha! Yes. We pinch the tape over the forehead so that even if they're

rendered a quadriplegic their eyebrows will still be intact. It's all

cosmetic, but then, that's what we're all about. Cosmetics.

>

>

> How many toys have we fallen for? I remember the Jaw Screw! It looked

like a midieval torture device, Never used it, but we carried it. Next

were MAST. The newest thing. Got to have them. State required them.

Cause an autotransfusion from the legs to the body core. Not. Doesn't

happen. KED. Must have this toy. Except that it was designed by its

inventor for something other than EMS use. Hare Traction Splint.

Designed by a former cop who started a company, DynaMed, that sold lots

of dreck to medics who didn't know any better than to buy it. No

research to support its use. Glenn Hare was a good guy, but he didn't

understand research. The Philadelphia Collar, then the rest of them that

tried to figure out differences between them and the Philly so they

could patent the devices. Massive advertising campaigns. All pretty

lame. No proven advantages from any of them. No proven advantage for any

sort of spinal immobilization. But we love toys. When we apply one of

these toys in the field, we get instant gratification. We think we have

done something really great! Sorry. Most of what we do is bulls**t and

has no effect on patient outcomes. We can apply all sorts of toys as

long as we do it ENROUTE to the hospital. That will make us feel good,

and maybe it will help, but if our patient needs an application of cold

steel, there's no evidence that anything we do in the field makes a bit

if difference.

>

>

> So some will buy the Whatzit C-Spine Device and their medics will

struggle to apply it, spending lots of time that would be better spent

on the road to the appropriate hospital.

>

>

> No benefits will result, but also no data will be generated, so we'll

all still tout our prejudices.

>

>

> GG

>

>

>

>

>

>

>

>

> Re: Are current cervical collars doing more

harm than good? New studies...

>

> >>> Dr. Ray Fowler states that " we should be splinting the cervical

spine " with some type of cervical splint. <<<

> So is Fowler disagreeing with Persse? Did he cite any studies to

support his assertion? Where's the beef? Where's the evidence? Is he

touting the latest model C-collar that has the little mini-spineboard

attached? Where's the literature to support that device over any other?

Does he have an interest in the device?

> It's not clear to me how one can apply that thing to a supine patient

without some manipulation of the C-spine and back. The video thing shows

it being applied to a conscious, upright-sitting model. Swell. Anybody

can do that, just like anybody can put the KED on a student model at the

NREMT exam. Real life is different. I want to see how they put it on a

guy who crashed his crotch rocket and is lying in the ditch without

moving the C-spine. I want to see them apply it when the patient's got 4

layers of clothing on including a leather Harley jacket. I want outcome

studies that show a significant improvement in survival as a result of

use of this device.

> Sorry to be the contrarian (actually I'm not sorry--this is what I

do) once again, but show me the proof!

> G

>

> Dr. Fowler says a lot of things.

>

> Kenny Navarro

> Dallas

>

> =

>

>

[Guest guest]

As far as I'm aware, Halo is just a different type of occlusive

dressing. Having never had the pleasure of needing to use an occlusive

dressing, I don't have any preference, but I'm sure some people do.

Alyssa Woods, FF/NREMT-B

> Yes I agree with your point Gene, anything that increases scene time

> which increases the time to definative care in trauma (expecially

> after the penetrating trauma study and conclusion) is not beneficial

> to the patient outcome. Whatever we utilyze must not increase scene

> times, our treatments should be enroute, getting the patient to a

> hard table and a cold steel knife. We should not just use a " new

> toy " and science should direct what we use. The sad thing is that I

> remember all of these toys you mention...I hate showing my age!

>

> Another device that Dr. Persse commented on is some type of EMS

> " Halo " . Has anybody seen or heard about that? Again, is it another

> " toy " ? There has to be an answer because based on the presented

> studies, I do feel that what we are currently doing may be doing

> harm. Thanks for your discussion. I still encourage more.

>

> Jon

>

>

> >

> > Ha! Yes. We pinch the tape over the forehead so that even if

> they're rendered a quadriplegic their eyebrows will still be intact.

> It's all cosmetic, but then, that's what we're all about. Cosmetics.

> >

> >

> > How many toys have we fallen for? I remember the Jaw Screw! It

> looked like a midieval torture device, Never used it, but we carried

> it. Next were MAST. The newest thing. Got to have them. State

> required them. Cause an autotransfusion from the legs to the body

> core. Not. Doesn't happen. KED. Must have this toy. Except that it

> was designed by its inventor for something other than EMS use. Hare

> Traction Splint. Designed by a former cop who started a company,

> DynaMed, that sold lots of dreck to medics who didn't know any

> better than to buy it. No research to support its use. Glenn Hare

> was a good guy, but he didn't understand research. The Philadelphia

> Collar, then the rest of them that tried to figure out differences

> between them and the Philly so they could patent the devices.

> Massive advertising campaigns. All pretty lame. No proven advantages

> from any of them. No proven advantage for any sort of spinal

> immobilization. But we love toys. When we apply one of these toys in

> the field, we get instant gratification. We think we have done

> something really great! Sorry. Most of what we do is bulls**t and

> has no effect on patient outcomes. We can apply all sorts of toys as

> long as we do it ENROUTE to the hospital. That will make us feel

> good, and maybe it will help, but if our patient needs an

> application of cold steel, there's no evidence that anything we do

> in the field makes a bit if difference.

> >

> >

> > So some will buy the Whatzit C-Spine Device and their medics will

> struggle to apply it, spending lots of time that would be better

> spent on the road to the appropriate hospital.

> >

> >

> > No benefits will result, but also no data will be generated, so

> we'll all still tout our prejudices.

> >

> >

> > GG

> >

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the

> cervical spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-

> spineboard attached? Where's the literature to support that device

> over any other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to

> see how they put it on a guy who crashed his crotch rocket and is

> lying in the ditch without moving the C-spine. I want to see them

> apply it when the patient's got 4 layers of clothing on including a

> leather Harley jacket. I want outcome studies that show a

> significant improvement in survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> > =

> >

> >

[Guest guest]

As far as I'm aware, Halo is just a different type of occlusive

dressing. Having never had the pleasure of needing to use an occlusive

dressing, I don't have any preference, but I'm sure some people do.

Alyssa Woods, FF/NREMT-B

> Yes I agree with your point Gene, anything that increases scene time

> which increases the time to definative care in trauma (expecially

> after the penetrating trauma study and conclusion) is not beneficial

> to the patient outcome. Whatever we utilyze must not increase scene

> times, our treatments should be enroute, getting the patient to a

> hard table and a cold steel knife. We should not just use a " new

> toy " and science should direct what we use. The sad thing is that I

> remember all of these toys you mention...I hate showing my age!

>

> Another device that Dr. Persse commented on is some type of EMS

> " Halo " . Has anybody seen or heard about that? Again, is it another

> " toy " ? There has to be an answer because based on the presented

> studies, I do feel that what we are currently doing may be doing

> harm. Thanks for your discussion. I still encourage more.

>

> Jon

>

>

> >

> > Ha! Yes. We pinch the tape over the forehead so that even if

> they're rendered a quadriplegic their eyebrows will still be intact.

> It's all cosmetic, but then, that's what we're all about. Cosmetics.

> >

> >

> > How many toys have we fallen for? I remember the Jaw Screw! It

> looked like a midieval torture device, Never used it, but we carried

> it. Next were MAST. The newest thing. Got to have them. State

> required them. Cause an autotransfusion from the legs to the body

> core. Not. Doesn't happen. KED. Must have this toy. Except that it

> was designed by its inventor for something other than EMS use. Hare

> Traction Splint. Designed by a former cop who started a company,

> DynaMed, that sold lots of dreck to medics who didn't know any

> better than to buy it. No research to support its use. Glenn Hare

> was a good guy, but he didn't understand research. The Philadelphia

> Collar, then the rest of them that tried to figure out differences

> between them and the Philly so they could patent the devices.

> Massive advertising campaigns. All pretty lame. No proven advantages

> from any of them. No proven advantage for any sort of spinal

> immobilization. But we love toys. When we apply one of these toys in

> the field, we get instant gratification. We think we have done

> something really great! Sorry. Most of what we do is bulls**t and

> has no effect on patient outcomes. We can apply all sorts of toys as

> long as we do it ENROUTE to the hospital. That will make us feel

> good, and maybe it will help, but if our patient needs an

> application of cold steel, there's no evidence that anything we do

> in the field makes a bit if difference.

> >

> >

> > So some will buy the Whatzit C-Spine Device and their medics will

> struggle to apply it, spending lots of time that would be better

> spent on the road to the appropriate hospital.

> >

> >

> > No benefits will result, but also no data will be generated, so

> we'll all still tout our prejudices.

> >

> >

> > GG

> >

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the

> cervical spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-

> spineboard attached? Where's the literature to support that device

> over any other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to

> see how they put it on a guy who crashed his crotch rocket and is

> lying in the ditch without moving the C-spine. I want to see them

> apply it when the patient's got 4 layers of clothing on including a

> leather Harley jacket. I want outcome studies that show a

> significant improvement in survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> > =

> >

> >

[Guest guest]

As far as I'm aware, Halo is just a different type of occlusive

dressing. Having never had the pleasure of needing to use an occlusive

dressing, I don't have any preference, but I'm sure some people do.

Alyssa Woods, FF/NREMT-B

> Yes I agree with your point Gene, anything that increases scene time

> which increases the time to definative care in trauma (expecially

> after the penetrating trauma study and conclusion) is not beneficial

> to the patient outcome. Whatever we utilyze must not increase scene

> times, our treatments should be enroute, getting the patient to a

> hard table and a cold steel knife. We should not just use a " new

> toy " and science should direct what we use. The sad thing is that I

> remember all of these toys you mention...I hate showing my age!

>

> Another device that Dr. Persse commented on is some type of EMS

> " Halo " . Has anybody seen or heard about that? Again, is it another

> " toy " ? There has to be an answer because based on the presented

> studies, I do feel that what we are currently doing may be doing

> harm. Thanks for your discussion. I still encourage more.

>

> Jon

>

>

> >

> > Ha! Yes. We pinch the tape over the forehead so that even if

> they're rendered a quadriplegic their eyebrows will still be intact.

> It's all cosmetic, but then, that's what we're all about. Cosmetics.

> >

> >

> > How many toys have we fallen for? I remember the Jaw Screw! It

> looked like a midieval torture device, Never used it, but we carried

> it. Next were MAST. The newest thing. Got to have them. State

> required them. Cause an autotransfusion from the legs to the body

> core. Not. Doesn't happen. KED. Must have this toy. Except that it

> was designed by its inventor for something other than EMS use. Hare

> Traction Splint. Designed by a former cop who started a company,

> DynaMed, that sold lots of dreck to medics who didn't know any

> better than to buy it. No research to support its use. Glenn Hare

> was a good guy, but he didn't understand research. The Philadelphia

> Collar, then the rest of them that tried to figure out differences

> between them and the Philly so they could patent the devices.

> Massive advertising campaigns. All pretty lame. No proven advantages

> from any of them. No proven advantage for any sort of spinal

> immobilization. But we love toys. When we apply one of these toys in

> the field, we get instant gratification. We think we have done

> something really great! Sorry. Most of what we do is bulls**t and

> has no effect on patient outcomes. We can apply all sorts of toys as

> long as we do it ENROUTE to the hospital. That will make us feel

> good, and maybe it will help, but if our patient needs an

> application of cold steel, there's no evidence that anything we do

> in the field makes a bit if difference.

> >

> >

> > So some will buy the Whatzit C-Spine Device and their medics will

> struggle to apply it, spending lots of time that would be better

> spent on the road to the appropriate hospital.

> >

> >

> > No benefits will result, but also no data will be generated, so

> we'll all still tout our prejudices.

> >

> >

> > GG

> >

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the

> cervical spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-

> spineboard attached? Where's the literature to support that device

> over any other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to

> see how they put it on a guy who crashed his crotch rocket and is

> lying in the ditch without moving the C-spine. I want to see them

> apply it when the patient's got 4 layers of clothing on including a

> leather Harley jacket. I want outcome studies that show a

> significant improvement in survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> > =

> >

> >

[Guest guest]

Wonderfully academic discussion we're having here, especially in light

of the lack of evidence that spinal immobilization *itself* improves

neurological outcomes...

Jon wrote:

>

> No Gene, Fowler is agreeing with Persse; not disagreeing. All of the

> studies that Dr. Persse stated in his presentation supported his

> statement. Fowler agrees with him and his statement that I quoted him

> was to me over lunch. And yes Kenny Fowler states a lot of things

> however he is agreeing with Persse and the other medical directors of

> the Eagles.

>

> The literature on this new device... go to their site like I did and

> look at it. I personally had it applied to me while I was laying down

> with a coat on and it didn't move me anymore than applying a regular

> c-collar. The video shows applying it with one person you still follow

> all current protocols by holding the head in " position found " . We did

> a field trial on it at MedStar in Ft Worth 3 years ago and the

> statement was made that " this thing is ahead of its time because it

> does something that we are doing right now. It is actually spliting

> the spine. " Now with the current studies, splinting the spine is what

> we probably should be doing. If we have a broken arm, we splint it in

> place...right? So why wouldn't we splint a fractured SPINE in place

> when it involves the spine. My point is now that it has been

> questioned that current methods may be causing harm, what are we going

> to do now? Are we just going to keep doing the same thing because that

> is ju st what we do? Or are we going to...OMG here it comes...CHANGE?

>

>

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> >

> >

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the cervical

> spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-spineboard

> attached? Where's the literature to support that device over any

> other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to see

> how they put it on a guy who crashed his crotch rocket and is lying in

> the ditch without moving the C-spine. I want to see them apply it when

> the patient's got 4 layers of clothing on including a leather Harley

> jacket. I want outcome studies that show a significant improvement in

> survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> >

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> >

> >

> >

> >

> >

> >

> > =

> >

> >

> >

[Guest guest]

Wonderfully academic discussion we're having here, especially in light

of the lack of evidence that spinal immobilization *itself* improves

neurological outcomes...

Jon wrote:

>

> No Gene, Fowler is agreeing with Persse; not disagreeing. All of the

> studies that Dr. Persse stated in his presentation supported his

> statement. Fowler agrees with him and his statement that I quoted him

> was to me over lunch. And yes Kenny Fowler states a lot of things

> however he is agreeing with Persse and the other medical directors of

> the Eagles.

>

> The literature on this new device... go to their site like I did and

> look at it. I personally had it applied to me while I was laying down

> with a coat on and it didn't move me anymore than applying a regular

> c-collar. The video shows applying it with one person you still follow

> all current protocols by holding the head in " position found " . We did

> a field trial on it at MedStar in Ft Worth 3 years ago and the

> statement was made that " this thing is ahead of its time because it

> does something that we are doing right now. It is actually spliting

> the spine. " Now with the current studies, splinting the spine is what

> we probably should be doing. If we have a broken arm, we splint it in

> place...right? So why wouldn't we splint a fractured SPINE in place

> when it involves the spine. My point is now that it has been

> questioned that current methods may be causing harm, what are we going

> to do now? Are we just going to keep doing the same thing because that

> is ju st what we do? Or are we going to...OMG here it comes...CHANGE?

>

>

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> >

> >

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the cervical

> spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-spineboard

> attached? Where's the literature to support that device over any

> other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to see

> how they put it on a guy who crashed his crotch rocket and is lying in

> the ditch without moving the C-spine. I want to see them apply it when

> the patient's got 4 layers of clothing on including a leather Harley

> jacket. I want outcome studies that show a significant improvement in

> survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> >

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> >

> >

> >

> >

> >

> >

> > =

> >

> >

> >

[Guest guest]

Wonderfully academic discussion we're having here, especially in light

of the lack of evidence that spinal immobilization *itself* improves

neurological outcomes...

Jon wrote:

>

> No Gene, Fowler is agreeing with Persse; not disagreeing. All of the

> studies that Dr. Persse stated in his presentation supported his

> statement. Fowler agrees with him and his statement that I quoted him

> was to me over lunch. And yes Kenny Fowler states a lot of things

> however he is agreeing with Persse and the other medical directors of

> the Eagles.

>

> The literature on this new device... go to their site like I did and

> look at it. I personally had it applied to me while I was laying down

> with a coat on and it didn't move me anymore than applying a regular

> c-collar. The video shows applying it with one person you still follow

> all current protocols by holding the head in " position found " . We did

> a field trial on it at MedStar in Ft Worth 3 years ago and the

> statement was made that " this thing is ahead of its time because it

> does something that we are doing right now. It is actually spliting

> the spine. " Now with the current studies, splinting the spine is what

> we probably should be doing. If we have a broken arm, we splint it in

> place...right? So why wouldn't we splint a fractured SPINE in place

> when it involves the spine. My point is now that it has been

> questioned that current methods may be causing harm, what are we going

> to do now? Are we just going to keep doing the same thing because that

> is ju st what we do? Or are we going to...OMG here it comes...CHANGE?

>

>

> >

> >

> >

> >

> >

> >

> >

> > Re: Are current cervical collars doing more

> harm than good? New studies...

> >

> >

> >

> >

> > >>> Dr. Ray Fowler states that " we should be splinting the cervical

> spine " with some type of cervical splint. <<<

> > So is Fowler disagreeing with Persse? Did he cite any studies to

> support his assertion? Where's the beef? Where's the evidence? Is he

> touting the latest model C-collar that has the little mini-spineboard

> attached? Where's the literature to support that device over any

> other? Does he have an interest in the device?

> > It's not clear to me how one can apply that thing to a supine

> patient without some manipulation of the C-spine and back. The video

> thing shows it being applied to a conscious, upright-sitting model.

> Swell. Anybody can do that, just like anybody can put the KED on a

> student model at the NREMT exam. Real life is different. I want to see

> how they put it on a guy who crashed his crotch rocket and is lying in

> the ditch without moving the C-spine. I want to see them apply it when

> the patient's got 4 layers of clothing on including a leather Harley

> jacket. I want outcome studies that show a significant improvement in

> survival as a result of use of this device.

> > Sorry to be the contrarian (actually I'm not sorry--this is what I

> do) once again, but show me the proof!

> > G

> >

> >

> >

> > Dr. Fowler says a lot of things.

> >

> > Kenny Navarro

> > Dallas

> >

> >

> >

> >

> >

> >

> >

> > =

> >

> >

> >