Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 From a technical standpoint, wouldn't spinal motion restriction be more appropriately descriptive? -Wes Ogilvie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 We use the term here! We stopped using Spinal Immobilization a few years back. Immobilization rarely if ever occurs. SMR is a more accurate term/goal of the procedure. Controversy > How many on the list use the term Spinal Motion Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all its lightness and > frivolity it has one serious purpose, one aim, one specialty, and it is > constant to it--the deriding of shams, the exposure of pretentious > falsities, the laughing of stupid superstitions out of existence; and that > whoso is by instinct engaged in this sort of warfare is the natural enemy of > royalties, nobilities, privileges and all kindred swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com/> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 It's currently titled " Spinal Immobilization " , but the next update will change the title to " Spinal Restriction " . Makes more sense. Jack Pitcock EMS Division Manager Baytown Health Dept EMS Controversy How many on the list use the term Spinal Motion Restriction (SMR) versus Spinal Immobilization. Bledsoe, DO, FACEP Midlothian, TX Ours is a useful trade, a worthy calling: with all its lightness and frivolity it has one serious purpose, one aim, one specialty, and it is constant to it--the deriding of shams, the exposure of pretentious falsities, the laughing of stupid superstitions out of existence; and that whoso is by instinct engaged in this sort of warfare is the natural enemy of royalties, nobilities, privileges and all kindred swindles, and the natural friend of human rights and human liberties. -Mark Twain Don't miss EMStock 2004! http://www.emstock.com <http://www.emstock.com> <http://www.emstock.com/ <http://www.emstock.com/> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 New from BTLS.. Lawyers are saying you can not fully Immobilize the spine. So, now we restrict further movement. --- Jack Pitcock wrote: > It's currently titled " Spinal Immobilization " , but > the next update will > change the title to " Spinal Restriction " . Makes > more sense. > > Jack Pitcock > EMS Division Manager > Baytown Health Dept EMS > > Controversy > > > How many on the list use the term Spinal Motion > Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all > its lightness and > frivolity it has one serious purpose, one aim, one > specialty, and it is > constant to it--the deriding of shams, the exposure > of pretentious > falsities, the laughing of stupid superstitions out > of existence; and that > whoso is by instinct engaged in this sort of warfare > is the natural enemy of > royalties, nobilities, privileges and all kindred > swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com> > <http://www.emstock.com/ > <http://www.emstock.com/> > > > > > > [Non-text portions of this message have been > removed] > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 Trying to now as BTLS mandates the change in terminology. It's hard to change from old habits though. I imagine the very legal-minded believe in the change. >>> bbledsoe@... 3/10/2004 2:00:14 PM >>> How many on the list use the term Spinal Motion Restriction (SMR) versus Spinal Immobilization. Bledsoe, DO, FACEP Midlothian, TX Ours is a useful trade, a worthy calling: with all its lightness and frivolity it has one serious purpose, one aim, one specialty, and it is constant to it--the deriding of shams, the exposure of pretentious falsities, the laughing of stupid superstitions out of existence; and that whoso is by instinct engaged in this sort of warfare is the natural enemy of royalties, nobilities, privileges and all kindred swindles, and the natural friend of human rights and human liberties. -Mark Twain Don't miss EMStock 2004! http://www.emstock.com <http://www.emstock.com/> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 I just document that we applied the CCollar, Back Board, CID and straps. Don't even use the word immobile or restrained. Tom LeNeveu Learning Paramedic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 , You ask some questions that ought to be answered, and also some of your comments merit a reply. So read below, please. Gene In a message dated 3/10/2004 10:35:55 PM Central Standard Time, taos2k2@... writes: Esquire Gandy, I agree with almost everything you said, but the purpose of my comments were to draw attention to the fact that many times fear of litigation is like a giant in the backs of people's minds. The way the original comments were presented seemed to convey that BTLS is telling everyone to exclusively use the term Spinal Mobility Restriction because an attorney said so. I don't think that the writer meant to say that BTLS is telling everyone to exclusively use the term Spinal Mobility Restriction because an attorney said so. BTLS develops its curriculum and its printed materials based upon Dr. Emery 's writings and those who are associated with him. I know Dr. , have taught BTLS with him, and he doesn't base what he says on what some attorney tells him. However, I believe that it is a little disingenuous to imply that Attorneys merely ask questions of " experts " . Isn't it true that many personal injury attorneys hire experts and pay them for their testimony? Yep. They do. I'm one of those experts that they hire. And I charge them for my services just the same as a plumber charges for his services, except that I get less than plumbers do. They ask the questions of " experts " who agree with them. Why in the world would anybody hire an expert that disagreed with them and have them testify? Won't happen. However, I have been asked many times to review a case and have told the attorneys that I either felt that there was no negligence or, when I'm on the other side, that there was clear negligence. Many times that was not what they wanted to hear. They paid me anyway because they sought my expertise, not my agreement. Contrary to popular belief, most attorneys seek the truth. Litigation costs them way too much to go into a trial with a position that is not supportable factually. You can, conceivably, hire an expert that will say whatever you want, but if you do that and you knowingly allow that expert to testify, you've committed an ethical violation that cannot only cost you the trial but your license to practice law. You see, the lawyers police their ranks much more stringently than the physicians do. If you knowingly put on false testimony, you may be guilty of subornation of perjury and may be charged criminally while losing your license to practice. Only the few drunks and dope heads would ever even think of doing that. Reputable lawyers don't. Further, an expert witness who doesn't know his stuff will be shredded by the other side. No lawyer wants that to happen, so the notion that lawyers pay witnesses to say what they want is pure hocum. There is much misunderstanding of the legal profession. It is quite popular to bash and denigrate lawyers. Most of those who do that have never even known one very well. The great mass of lawyers are honest, sincere, and ethical practitioners, just as are the great mass of EMTs, Paramedics, Nurses, and Physicians. Many personal injury lawyers do things that suit their own needs, and I think everyone here understands how convoluted the truth can become when you have to testify after a physician who makes a living off of testifying in civil trials. Those physicians are well known, and they can be forced to disclose the clients that they have testified for in the past, how much money they were paid, and all the details. Physicians who are " whores " for one side or another are soon discredited simply because there is too much information available to not only attorneys but lay people, and the average juror won't buy the testimony of a plaintiff or defense whore and, yes, there are whores both for the plaintiff and defense, but they are getting fewer and fewer. I also have to disagree with you that attorneys don't dictate anything. In the formal sense, that is certainly true. However, in the practical sense, nothing could be further from the truth. Litigation has become a central concern in the practice of almost every aspect of health care. I suppose we will simply have to agree to disagree. But you don't demonstrate how attorneys dictate protocol or terminology. You say that litigation is a central concern, but that fails to show how an attorney can dictate a standard of care, a definition, or any other fact. Facts are facts, and all factual testimony is subject to stringent cross-examination. So, you see, I don't think you actually have much knowledge or experience of the trial process or how litigation proceeds. You demonstrate the popular prejudices and scapegoating against lawyers that are prevalent today, but your facts and logic don't hold up. Come with me some time and I'll introduce you to some lawyers and judges who are the most ethical, honest, and hard working people you'll ever find. So please don't bash a whole group of anonymous people you don't know. That's prejudice. Think critically about what happens, seek the facts and the truth, and then make up your mind. When you do that, and if you do it honestly and intelligently, you won't make blanket statements about lawyers doing this and lawyers doing that. Of course, it is popular to hold up OJ's trial as the poster-trial for bad practice and bad results. Suffice it to say that, " that's California. " There is no other jurisdiction in the US that is as insane as California in how its judicial system works. In my judgment, the prosecuting attorneys in OJ were as stupid, amateurish, and foolish as any bunch of so-called first line prosecutors I have ever seen. Moreso. Marcia would make even her mother want to slap her after saying just about one sentence, and Darden committed the cardinal sin, that of doing a courtroom experiment that you didn't know exactly what the result would be. DUH. First year law students could have done a better job. And the judge quickly lost his mind in the glare of the media. It's interesting that he hasn't been heard from again, isn't it. So there are dumb, stupid, and even crooked attorneys, but there are also dumb, stupid, and crooked physicians, nurses, and medics. For example, two medics from MedStar in Ft Worth just got indicted for felony sexual abuse of a child. Does that reflect on the 99% of the other MedStar medics who are honest and good. Of course not. , the practice of medicine at all levels is dynamic and constantly changing. Few things today are the same as they were when I became a medic in July of 1981. I have had to revise and change my attitudes, practices, terminologies, and interventions again and again. The only constant is change. Lawyers just present the real, true, facts. Yes, they can argue about that the facts are, but the jury is the one that decides. Jurors are way too smart to fall for cheap tricks, smoke and mirrors. Just look at the Martha trial. Best, and please keep speaking your mind and engaging us. GG Best wishes to you and yours. - RE: Controversy New from BTLS.. Lawyers are saying you can not fully Immobilize the spine. So, now we restrict further movement. --- Jack Pitcock wrote: > It's currently titled " Spinal Immobilization " , but > the next update will > change the title to " Spinal Restriction " . Makes > more sense. > > Jack Pitcock > EMS Division Manager > Baytown Health Dept EMS > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 , What your physicians are doing is letting their emotions overcome their brains. What they ought to be looking at is the research and literature that backs the Maine protocol. There are practically NO cases where there were undiscovered spinal injuries when the MP was used correctly. I challenge you to find one. OTOH, pain management issues are now coming to the forefront of litigation. So your docs, in the irrational fear that they may be sued for their troops missing a spinal injury are subjecting themselves to suit for failing to recognize that spineboard are cruel and unusual devices and subject their occupants to often excruciating pain, pressure sores, and so forth. This is not clear thinking. True, anybody can file a lawsuit against anybody anytime, but on a slip and fall case, for example, no attorney is going to file unless the facts are there because he'll lose his sweet ass on the case if he doesn't win. It costs megabucks to finance litigation, and the lawyer is putting his own money up. No win, no money. Lawyer pays the bills. There are a few jurisdictions in Texas, mostly in the Golden Triangle, that are famous for litigation, but when you actually go to the courthouse, pull out the cases, read them, and evaluate them, the conclusions that you'll come to will likely be far different from what you think you'd find. Most of those lawsuits are based on real and honestly stated injuries to little people just like me and you. Do you suggest that people not have any recourse for legitimate injury? Are you so mistrustful of your fellow man that you don't feel that a jury of regular people can sift through the facts and make a fair and honest decision about who's at fault and who should be paid? The Mc's sort of case is one in a million. And, BTW, when you actually read the case, you find that Mcs had at least 700 previous claims filed against it before the LOL filed hers, alleging burns from coffee that was served at 180 degrees F. Mcs was punished for its arrogance. Best, GG GG In a message dated 3/10/2004 11:13:07 PM Central Standard Time, taos2k2@... writes: Mike, I think the way to avoid lawsuits is to provide the best patient care possible and continue your education so that the care you provide is in keeping with the most current standards. However, I have been told that the reason we cannot use the Maine Protocol for " spinal mobility restriction " is because of the fear of litigation. I won't argue the rationality of that because the physicians around here have taken a real beating from lawsuits. I live in an area that has a problem with frivolous lawsuits. Whether they make it to trial or get thrown out in discovery is really immaterial because they cost precious money to defend against. I have had MANY patients who slip on something in the grocery store and make comments about calling an attorney or patients who are involved in a minor traffic collision and are on the phone with a relative getting an attorney's name. So yes, it does enter into my mind on those occasions. One may argue that providing excellent patient care is the surest way to prevent lawsuits. I agree with you completely and I try to do my damndest for every patient that I come into contact with. However, lawsuits do not have to have any merit to be filed. My concern with lawsuits is not a function of the level of care I provide, but rather of the environment in which I work. Regards, - Controversy > > > How many on the list use the term Spinal Motion > Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all > its lightness and > frivolity it has one serious purpose, one aim, one > specialty, and it is > constant to it--the deriding of shams, the exposure > of pretentious > falsities, the laughing of stupid superstitions out > of existence; and that > whoso is by instinct engaged in this sort of warfare > is the natural enemy of > royalties, nobilities, privileges and all kindred > swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com> > <http://www.emstock.com/ > <http://www.emstock.com/> > > > > > > [Non-text portions of this message have been > removed] > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 Esquire Gandy, I agree with almost everything you said, but the purpose of my comments were to draw attention to the fact that many times fear of litigation is like a giant in the backs of people's minds. The way the original comments were presented seemed to convey that BTLS is telling everyone to exclusively use the term Spinal Mobility Restriction because an attorney said so. However, I believe that it is a little disingenuous to imply that Attorneys merely ask questions of " experts " . Isn't it true that many personal injury attorneys hire experts and pay them for their testimony? They ask the questions of " experts " who agree with them. Many personal injury lawyers do things that suit their own needs, and I think everyone here understands how convoluted the truth can become when you have to testify after a physician who makes a living off of testifying in civil trials. I also have to disagree with you that attorneys don't dictate anything. In the formal sense, that is certainly true. However, in the practical sense, nothing could be further from the truth. Litigation has become a central concern in the practice of almost every aspect of health care. I suppose we will simply have to agree to disagree. Best wishes to you and yours. - Controversy > > > How many on the list use the term Spinal Motion > Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all > its lightness and > frivolity it has one serious purpose, one aim, one > specialty, and it is > constant to it--the deriding of shams, the exposure > of pretentious > falsities, the laughing of stupid superstitions out > of existence; and that > whoso is by instinct engaged in this sort of warfare > is the natural enemy of > royalties, nobilities, privileges and all kindred > swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com> > <http://www.emstock.com/ > <http://www.emstock.com/> > > > > > > [Non-text portions of this message have been > removed] > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 , I can honestly say that when it comes time for me to make a decision regarding treatment for a patient, there is never any point where I think about the law, possible litigation, or lawyers. I make all of my judgments based on what I know of the treatments available to me, the training that I've come to rely on and the patient's presentation. (Actually, the only time that it has EVER occurred to me was when a mom met me at the end of her driveway carrying her 7 year old daughter who was unconscious and in status asthma. Mom rode in with us. Mom, in passing, just decided to tell me that she was a lawyer. Beyond the " Oh, great?! " self-thought sarcasm, the thought never re-entered my mind until completion of the call. but, I digress). If a provider is constantly worried about litigation, then the provider needs to shore up his skills and education quickly. It is far more dangerous to allow your hands to be providing treatment without 100% attention to detail. That is inviting mistakes to happen. Just some thoughts. Mike Re: Controversy Esquire Gandy, I agree with almost everything you said, but the purpose of my comments were to draw attention to the fact that many times fear of litigation is like a giant in the backs of people's minds. The way the original comments were presented seemed to convey that BTLS is telling everyone to exclusively use the term Spinal Mobility Restriction because an attorney said so. However, I believe that it is a little disingenuous to imply that Attorneys merely ask questions of " experts " . Isn't it true that many personal injury attorneys hire experts and pay them for their testimony? They ask the questions of " experts " who agree with them. Many personal injury lawyers do things that suit their own needs, and I think everyone here understands how convoluted the truth can become when you have to testify after a physician who makes a living off of testifying in civil trials. I also have to disagree with you that attorneys don't dictate anything. In the formal sense, that is certainly true. However, in the practical sense, nothing could be further from the truth. Litigation has become a central concern in the practice of almost every aspect of health care. I suppose we will simply have to agree to disagree. Best wishes to you and yours. - Controversy > > > How many on the list use the term Spinal Motion > Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all > its lightness and > frivolity it has one serious purpose, one aim, one > specialty, and it is > constant to it--the deriding of shams, the exposure > of pretentious > falsities, the laughing of stupid superstitions out > of existence; and that > whoso is by instinct engaged in this sort of warfare > is the natural enemy of > royalties, nobilities, privileges and all kindred > swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com> > <http://www.emstock.com/ > <http://www.emstock.com/> > > > > > > [Non-text portions of this message have been > removed] > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 Mike, I think the way to avoid lawsuits is to provide the best patient care possible and continue your education so that the care you provide is in keeping with the most current standards. However, I have been told that the reason we cannot use the Maine Protocol for " spinal mobility restriction " is because of the fear of litigation. I won't argue the rationality of that because the physicians around here have taken a real beating from lawsuits. I live in an area that has a problem with frivolous lawsuits. Whether they make it to trial or get thrown out in discovery is really immaterial because they cost precious money to defend against. I have had MANY patients who slip on something in the grocery store and make comments about calling an attorney or patients who are involved in a minor traffic collision and are on the phone with a relative getting an attorney's name. So yes, it does enter into my mind on those occasions. One may argue that providing excellent patient care is the surest way to prevent lawsuits. I agree with you completely and I try to do my damndest for every patient that I come into contact with. However, lawsuits do not have to have any merit to be filed. My concern with lawsuits is not a function of the level of care I provide, but rather of the environment in which I work. Regards, - Controversy > > > How many on the list use the term Spinal Motion > Restriction (SMR) versus > Spinal Immobilization. > > > Bledsoe, DO, FACEP > > Midlothian, TX > > > > Ours is a useful trade, a worthy calling: with all > its lightness and > frivolity it has one serious purpose, one aim, one > specialty, and it is > constant to it--the deriding of shams, the exposure > of pretentious > falsities, the laughing of stupid superstitions out > of existence; and that > whoso is by instinct engaged in this sort of warfare > is the natural enemy of > royalties, nobilities, privileges and all kindred > swindles, and the natural > friend of human rights and human liberties. > > -Mark Twain > > > > Don't miss EMStock 2004! > > http://www.emstock.com <http://www.emstock.com> > <http://www.emstock.com/ > <http://www.emstock.com/> > > > > > > [Non-text portions of this message have been > removed] > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 Dear Esquire Gandy, You are a very effective advocate for your profession, and I appreciate that. Likewise, I applaud your ethical standards and commitment to fairness and the integrity of the judicial process. I apologize if you believe that my comments represented a blanket characterization of attorneys in general, as that was not my intention. Your assumptions about me are correct. I am not a legal eagle, and although I consider myself an educated individual who has a respectable understanding of a variety of things, I can't argue this with you on your level. Right as you are, however, I have found that it is neither polite nor constructive to make assumptions about a person's background using such limited contact as reference. My perception of some particular attorneys may indeed be jaded, but your apparent love of your profession also presents a unique and possibly subjective prism through which you view the profession. Try as we may, each of us are subject to our own proclivities. My experiences have led me to believe that the threat of lawsuits does have a substantial impact on EMS. Whether that impact is justified or not is another question. As an example, the service I work for part-time will not adopt selective spinal immobilization protocols, despite the mountain of supporting evidence, because of fear of a lawsuit. Would it be different if the threat of lawsuit were removed? Yes. Perhaps I should have used a clearer choice of words in my earlier statement so as not to give the impression that attorneys " dictate " certain actions. I meant to point out that the potential for litigation against EMS and other health care fields has created an environment that has impacted the EMS operations I have been involved with. Warmest Regards, - RE: Controversy New from BTLS.. Lawyers are saying you can not fully Immobilize the spine. So, now we restrict further movement. --- Jack Pitcock wrote: > It's currently titled " Spinal Immobilization " , but > the next update will > change the title to " Spinal Restriction " . Makes > more sense. > > Jack Pitcock > EMS Division Manager > Baytown Health Dept EMS > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 My last thought in treating my patients is lawsuit. If I follow my nose and call for help when I am confused I believe that I will provide my patients the best possible care. Most days the idea of being sued never enters my mind till I am back at my station finishing the paper work and imputing it into the computer. I have seen lawsuits devastate Paramedics and families of the paitents. They are never seem to have great out comes for all those invovled. For the time being I educate myself, practice my skills and ask lots of questions of those who know so much more than I. This seems to keep the lawyers away, (FOR NOW ) Tom LeNeveu Quiet Learning Paramedic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 Well Ms. Pate, I am refreshed and learning something anew. Tom LeNeveu Learning Paramedic In a message dated 3/11/2004 8:46:02 AM Central Standard Time, mpate1104@... writes: You may not write the word " immobile " but since " CID " stands for " cervical immobilization device " , if you write " CID " you are saying that you immobilize at least the cervical spine. Maxine Pate hire ----- Original Message ----- I just document that we applied the CCollar, Back Board, CID and straps. Don't even use the word immobile or restrained. Tom LeNeveu Learning Paramedic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 I would like to point out that possibly the ability or nonability to do selective spinal immobilization rests not with the misinterpretation of the findings in favor of selective spinal immobilization, but with the possible consequences from having this procedure done by untrained individuals. We must realize that some medical control physicians do not feel as comfortable with allowing certain procedures to be implemented due to not feeling comfortable with the EMS professionals that will be doing the procedure. I work with one that has a hard time allowing certain procedures, the reason is due to a complication with a patient in the past. Is this a legitimate reason, of course it is? A physicians doubts do not always come from EMS not doing our job, it could be a recent event not caused by EMS fault but it will effect the way we do our care. We must always be on guard to do our best and continue to strive for the best in our patient care. Only then will we be able to denounce the myth that we are not capable of doing the job. Working well and being able to communicate with our medical control physician can also be a turning point on doing or not doing procedures. Just a thought on the matter. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 I would like to point out that possibly the ability or nonability to do selective spinal immobilization rests not with the misinterpretation of the findings in favor of selective spinal immobilization, but with the possible consequences from having this procedure done by untrained individuals. We must realize that some medical control physicians do not feel as comfortable with allowing certain procedures to be implemented due to not feeling comfortable with the EMS professionals that will be doing the procedure. I work with one that has a hard time allowing certain procedures, the reason is due to a complication with a patient in the past. Is this a legitimate reason, of course it is? A physicians doubts do not always come from EMS not doing our job, it could be a recent event not caused by EMS fault but it will effect the way we do our care. We must always be on guard to do our best and continue to strive for the best in our patient care. Only then will we be able to denounce the myth that we are not capable of doing the job. Working well and being able to communicate with our medical control physician can also be a turning point on doing or not doing procedures. Just a thought on the matter. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 You may not write the word " immobile " but since " CID " stands for " cervical immobilization device " , if you write " CID " you are saying that you immobilize at least the cervical spine. Maxine Pate hire ----- Original Message ----- I just document that we applied the CCollar, Back Board, CID and straps. Don't even use the word immobile or restrained. Tom LeNeveu Learning Paramedic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 This is the issue I am facing. We are, as we speak (write), in the process of revising the 5-volume paramedic book. BTLS haws gone to the term Spinal Motion Restriction while PHTLS is still using spinal immobilization. I called Jeff Salamone, MD, and he stated that PHTLS will probably stay with spinal immobilization for 6th edition. Thus, what do we do with the textbook? Here in Texas, SMR is commonplace. In Upstate NY, they have not heard of it. The publishers (largely NY-based) are very prone to political correctness. We can't use B.C. (before Christ) with dates, instead must use B.C.E., can't use proprietary names (per se) and so on. We can't call female paramedics " ambulance gals " anymore either. Anyway, any suggestions or thoughts as to whether SMR is the more accepted term in the US would be appreciated. BEB Bledsoe, DO, FACEP Midlothian, TX Ours is a useful trade, a worthy calling: with all its lightness and frivolity it has one serious purpose, one aim, one specialty, and it is constant to it--the deriding of shams, the exposure of pretentious falsities, the laughing of stupid superstitions out of existence; and that whoso is by instinct engaged in this sort of warfare is the natural enemy of royalties, nobilities, privileges and all kindred swindles, and the natural friend of human rights and human liberties. -Mark Twain Don't miss EMStock 2004! http://www.emstock.com <http://www.emstock.com/> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 SSI is rooted in some pretty good science. In the 70s and 80s we practiced a form of SSI. If we hought they had a MOI or symptoms of a spinal injury, then we applied immibilization. In the 80s somebody decided that EMTs were too stupid to determine when and where to provide spinal immibilization and, instead, taught them to immobilize everybody. Finally, many of said, " enough of this horse shit. " If they can be instructed when to give potentially-lethal drugs, then we can have them apply SSI. We have been slowly introducing it. Somebody on this list said, " I don't base my patient care on fear of being sued. " If you do not practice SSI, then you do. I can say the same thing, but will reflexly order tests and x-rays that I don't really need just to " buff the chart " in case a local TV attorney goes fishing to help support their client's mentality. I know this will piss off Gene, Wes and --but I am all for English rule! They will all tell me how wrong I am at EMStock. It's all goood...... Bledsoe, DO, FACEP Midlothian, TX Ours is a useful trade, a worthy calling: with all its lightness and frivolity it has one serious purpose, one aim, one specialty, and it is constant to it--the deriding of shams, the exposure of pretentious falsities, the laughing of stupid superstitions out of existence; and that whoso is by instinct engaged in this sort of warfare is the natural enemy of royalties, nobilities, privileges and all kindred swindles, and the natural friend of human rights and human liberties. -Mark Twain Don't miss EMStock 2004! http://www.emstock.com Re: Controversy I would like to point out that possibly the ability or nonability to do selective spinal immobilization rests not with the misinterpretation of the findings in favor of selective spinal immobilization, but with the possible consequences from having this procedure done by untrained individuals. We must realize that some medical control physicians do not feel as comfortable with allowing certain procedures to be implemented due to not feeling comfortable with the EMS professionals that will be doing the procedure. I work with one that has a hard time allowing certain procedures, the reason is due to a complication with a patient in the past. Is this a legitimate reason, of course it is? A physicians doubts do not always come from EMS not doing our job, it could be a recent event not caused by EMS fault but it will effect the way we do our care. We must always be on guard to do our best and continue to strive for the best in our patient care. Only then will we be able to denounce the myth that we are not capable of doing the job. Working well and being able to communicate with our medical control physician can also be a turning point on doing or not doing procedures. Just a thought on the matter. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 , I find that most trends in the US typically start in the Southwest and move slowly to the Northeast. The exception to this would be anything that originated in the North (obviously). Your question was in regards of supporting terminology and I would have to say that in the absence of a noticeable trend geographically, identify the trend professionally or set the trend to what you feel it should be. I would default to the most appropriate use of the terms and the more exact definitions. Hope that helps. Mike Controversy This is the issue I am facing. We are, as we speak (write), in the process of revising the 5-volume paramedic book. BTLS haws gone to the term Spinal Motion Restriction while PHTLS is still using spinal immobilization. I called Jeff Salamone, MD, and he stated that PHTLS will probably stay with spinal immobilization for 6th edition. Thus, what do we do with the textbook? Here in Texas, SMR is commonplace. In Upstate NY, they have not heard of it. The publishers (largely NY-based) are very prone to political correctness. We can't use B.C. (before Christ) with dates, instead must use B.C.E., can't use proprietary names (per se) and so on. We can't call female paramedics " ambulance gals " anymore either. Anyway, any suggestions or thoughts as to whether SMR is the more accepted term in the US would be appreciated. BEB Bledsoe, DO, FACEP Midlothian, TX Ours is a useful trade, a worthy calling: with all its lightness and frivolity it has one serious purpose, one aim, one specialty, and it is constant to it--the deriding of shams, the exposure of pretentious falsities, the laughing of stupid superstitions out of existence; and that whoso is by instinct engaged in this sort of warfare is the natural enemy of royalties, nobilities, privileges and all kindred swindles, and the natural friend of human rights and human liberties. -Mark Twain Don't miss EMStock 2004! http://www.emstock.com <http://www.emstock.com/> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2004 Report Share Posted March 11, 2004 , Thanks for the nice note. No apologies are ever necessary when intelligent and civil argument is carried on. I do not take personally much of anything, and I realize that you were simply expressing your views. I hoped to focus your thinking somewhat and perhaps I did. I have known physicians that were afraid of lawsuits almost to the point of paranoia; and truly HATED attorneys. I once had an attorney in my paramedic class that one of the ER docs refused to let do clinicals with him just because the guy was a lawyer. As to the spinal precautions protocol, in time it will be recognized as standard of care and they will finally adopt it, but not until they are completely convinced that it's a safe procedure. I appreciate your comments at any time. Gene Quote Link to comment Share on other sites More sharing options...
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