No more SMR or C-Collar?

RickyRescue562

Forum Ride Along
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On my off day, i witnessed a TC and went to go check it out. bystanders extricated her and laid her on the street while doing questionable maneuvers. When I took over we did all the basics and I assessed her. When Fire pulls up, they don't strap her down or put a C-Collar on. Why is that?

Also: I know San Diego stopped using them, but why?
 

DesertMedic66

Forum Troll
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Because we have learned through research that placing patients on backboard was doing more harm and many places have moved to using the NEXUS/NSAID criteria for determining what patients are candidates for SMR/c-collars.
 

WolfmanHarris

Forum Asst. Chief
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It took forever for my jurisdiction to get on board (our provincial bureaucracy has been notoriously slow to adapt in the past but it getting better). We're collars only and only for pt's that don't meet Canadian C-Spine rule, boards for extrication only and can be removed once on stretcher.

Essentially SMR was only ever done because it seemed to make intuitive sense when it was developed, but as a body of research has been built we've come to understand that there is no evidence of benefit and known harms. Furthermore, the very premise that what were were doing was meaningfully immobilizing the spine was shown to be inaccurate as well. Additional features like the standing take down, or manhandling pt's out of vehicles have also been shown to cause more movement of the spinal column than having them stand and pivot.
 

akflightmedic

Forum Deputy Chief
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Let's take something which is naturally CURVED and shaped to load bear weight at different angles and then strap it to a STRAIGHT board to protect it, thereby cause uneven weight distribution and stress in places where it normally would not have it. Makes sense to me...
 

Aprz

Forum Deputy Chief
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