Anyone who follows the writing of emergency physician and author Dr. Bryan Bledsoe knows that he's not afraid to challenge many of the things we take for granted in EMS.
Among other things, he has in the past been critical of what he sees as the overuse of air medical transports, has wondered not only about the usefulness of CISD, but also questioned whether the process actually increases the psychological trauma of high-stress incidents.
He has a really interesting article on JEMS.com right now outlining a series of studies that jibe with Dr. Bledsoe's distrust of the sacred cow.
His thought-provoking column is a round up of studies, some of which have been inexplicably ignored in the US for over a decade, like the one comparing neurological outcomes in trauma patients between Albequerque, where aggressive c-spine immobilization is the norm, and Malaysia, where c-spine immobilization is unheard of.
Interestingly, the study found that the neurological outcomes in Malaysia were better.
This study was published in 1998, and yet we continue to strap thousands of people a year to hard plastic boards without a second thought.
Other studies Dr. Bledsoe highlights include one that suggests IV epi is of little use in cardiac arrests and another that proposes using D10 for acute hypoglycemics versus D50.
Check out the column, I don't think you'll be disappointed.
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