An athletic trainer (Bob Duchardt) from another site kindly gave me
permission to reproduce his comments on the Elam injury situation.

Mel Siff

----------------------

Thanks for the follow-up to your original post on this issue of the spinal
injury. I have become accustomed to the thoughtfulness behind, and the
accuracy of your writing, but must confess to being concerned that this might
be one time when you had over-stepped yourself. Clearly, my concern was
premature and for that I am most thankful.

A few years ago I made the same mistake as the ATCs involved in the case you
described. On a Wednesday afternoon I was in attendance at a Junior Varsity
FB game and observed one of my kids collide violently with another producing
an axial force through his spine. He lay on the field complaining of
exquisite pain in his mid spine. I called the EMS folks and had him
transported to an ER only to find out that he had no skeletal or neurological
injury.

Then on the following Saturday one of my varsity players did the same thing.
On the field he also complained of severe mid-spine pain and I believed that
he should have been taken off on a board. But he convinced me that he could
walk off, which I allowed him to do, with apparently no difficulty. After
about 15 minutes SITTING on the bench he finally admitted that his pain was
unbearable, at which time I placed him supine and summoned the EMS. After 45
more minutes of waiting for them (don't even ask why?) his father decided to
take him to the ER which was less than 1/4 mile away. The ER Doc declared
him to be fracture free and neurologically intact and sent him home in the
car with the parents. On Monday AM a radiologist read the films and found a
compression fracture at T-7.

I concluded that:

1. I wasn't so dumb after all since the ER Doc had missed the injury with
the benefit of x-ray, and
2. I was dumber than I thought because I had been lulled into a false sense
of security with the second kid because the first kid had turned out OK even
when my index of suspicion was very high.

Incidently, neither of those kids demonstrated any neurological signs or
symptoms.

My point is that we ATCs see so much stuff that ought to be serious and which
turns out not to be so, that we begin to forget "The Rules". Incidents such
as this current one serve to call us back to basics and to remind us of our
inherent fallibility. And rather than hammering you or anyone else for
calling us to task for screwing up, we ought to take a hard look at
ourselves and get our pompous backsides back to fundamentals. And we ought
to be thanking you or anyone else who snaps us back to attention.

So, for all of us who want to do this job correctly, Thank You!!

Bob Duchardt
[log in to unmask]

PS You may recall the flap over a pro basketball player's case a few years
ago when during the first half of a game he was rendered unconscious, handled
with kid gloves and by the book on the site of his injury, only to
return and play the second half of that game. Many of our ATC colleagues
called the medical staff covering that game to task for their blatant
"disregard" of "The Rules". I can't understand why so many are attempting to
rationalize this action away.

--------------------------------

Dr Mel C Siff
Denver, USA
<http://www.egroups.com/group/supertraining>




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