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problem with collar was that no one had the 'nerve'/testicals to put their hand under the flap of tissue, elevate it and get the collar on....Actuallyt, the medic did think about it and knew the breathing would be more difficult bolt upright, the patient was found in a tripod position, leaning his head down and neck slightly flexed....they put 2 big towel rolls on either side, taped them to a short board and got him in sitting on the stretcher. I shot a lateral xray then cleared him clinically and took off the rolls.
This illustrates how in both the civilian world and military world, not everything fits the books mold....weigh your risks and benefits and go with your instincts. I believe some of the 18D's and docs from the field will agree with this. Protocols fit ~75% of all patients, military, civilian , etc, this means 25% of the time it's you, your experience, some luck, alot of intuition and memory from a conversation you had sometime in your past with ssomeone that tried to educate you for just this problem and you laughed/blew it off thinking "I'll never see that!" well you may have just saved someones life by remembering that advice.
ss
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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