Dumb Stuff We Gotta Do

Well, one cat’s outta the bag. In the continued debate over the efficacy of prehospital spinal immobilization, it would appear from a study published the January 2010 issue of the Journal of Trauma that prehospital spinal immobilization doubles the risk of death for certain patients. Researchers at Johns Hopkins looked at 45,284 penetrating trauma patients in the National Trauma Data Bank. Of these, patients who received prehospital spinal immobilization consistently had double the mortality of those who did not receive this time consuming and potentially compromising treatment in the field. Curiously, 30 of the 45,284 patients who were shot or stabbed actually had spinal injuries (0.01%). Yet, further analysis demonstrated it took immobilizing only 66 patients to result in one death; saving one life with spinal immobilization took 1,032 backboard jobs. Hmmm, that translates to causing more than 15 deaths in order to save one life. Jeepers! Not very hard to see why the authors concluded that prehospital spinal immobilization results in higher mortality in patients with penetrating trauma and should not be routinely used. Another example of dumb stuff we gotta do. Hopefully, changes are coming.

Mike McEvoy
EMS Editor – Fire Engineering