Say It Isn't So by Gregory L. Henry, MD
Friday, February 19, 2010 
Gregory L. Henry, MDAnother sacred cow in emergency medicine is being butchered. I was once reminded that sacred cows made the tastiest intellectual burgers and it seems that the surgeons agree. This month’s issue of the Journal of Trauma has an interesting article in which they used cadavers to confirm that applying cervical collars to the neck of trauma patients may actually cause distraction, harm and compression of the spinal cord. When will the heresy end? Things we have done for years are now being shown to be useless, surprise!!! I could barely stand it when they took beta blockers away from most of my patients with acute coronary syndromes. It was absolutely painful. It was near mortifying when it was shown that figure of eight dressings actually impeded the healing of most clavicle fractures. I guess the only constant in medicine is still change and what is today’s great truth is tomorrow’s folly. A very wise professor, who I had in medical school, once said that he was perfectly well aware of half of what he was telling us was wrong. He just didn’t know which half that it was. So on we trudge changing our activity. Finding out that blowing in the mouth does very little in CPR and that the drug box is basically useless and that most of what we do for the swine flu doesn’t work reconfirms the old adage from Dr. Hook and the medicine show “Money for Nothing and Chicks for Free”.
Reader Comments (1)
Is anyone else tired of the one-size-fits-all approach to medicine these days? When I was a resident, we published a case report of transient paraplegia caused by application of a collar, that was fortunately reversed with its removal. I learned to put clavicle straps on a fractured clavicle, stopped when the literature said they don't help, and after a positive personal experience with a strap after a fractured clavicle, now offer patients the option. After almost 3 decades of practice, I still don't know what to make of CPR. It seems to me the Journal of Trauma paper is piece of data to keep in mind when caring for individual patients......as well as another bullet in the arsenal of the plaintiffs' bar.
After enjoying a number of Dr. Henry's talks, I was surprised to find him fan of Dr. Hook (though I think the lyric quoted was from Dire Straits). Might I suggest "Freakin' at the Freaker's Ball"; certainly politically incorrect, but somewhat descriptive of Saturday night in my ED.