undoubtly, are you suggesting I don't know the course of the treatment after the pt reaches the hospital or how to care for different age groups? But look at the treatment of spinus or transverse process fractures and many other non subluxations. what weight is given to ischemic cord injury (by far the most common) rather than transection or penetration? There has to be a very serious injury for a spinal surgery to be attempted.
There is also the knowledge that those with c or t fractures also have fractures of the opposite which show up on imaging and are often missed during examination. The day there is a one size fits all trauma treatment, I am quiting.
We could also talk about osteomalacia and osteoporosis in the elderly too, but i am trying hard to work with what was given and not debate every possibility. c'mon.
and I agree with this fully, but there is a difference between realistic index of suspicion, especially when you consider the rareness of cord injuries in a modern automobile and mechanism by speed or damage shown not to be reliable.
Additionally without critical thinking, there can be no improvement of patient care.
You have seriously taken this at a personal level.
I am quoting things that every Med Student learns as they come to educate themselves at a trauma center.
Did you notice my comments:
The anatomically narrow thoracic spinal canal also leads to a high incidence of associated neurologic complications. The higher the rib fxs the more chance of also finding spinal injuries. The younger the child, the more chance of spinal injuries since it takes great force to break the flexible ribs of the very young.
Without critical thinking and assessing the patient for more than just the obvious or from a limited knowledge, you have a patient with a life changing event in a wheel chair, suprapubic catheter and a daily bowel program.
Blankets statements or intentionally blowing off other possibilities are signs of irresponsible teaching and guidance in a world where accidents don't always happen as perfectly as some would like. You also can not ignore other disease processes and age which are also taken into consideration in trauma activation in some areas. Doing a thorough assessment means considering different possibilities and not just selective things to make YOUR own point. Do what is best for the patient.
The situation given is a flail chest. Do some research or spend some time at a trauma center or spinal injury rehab center. Shortcuts are great for the very experienced and properly educated but should not be taught for all nor should assumptions always be made especially when the literature may state otherwise. The medical director of the EMT student you were questioning may have a stack of literature to base his/her protocols from.
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