I can't imagine how an extrication could cause a cord injury, if it wasn't
already there following the RTA, Nick. That would presuppose an injury of
such violence as to produce an unstable cervical spine yet stopping short of
actual cord injury, followed by an extrication attempt which then pushed the
c-spine further to produce the cord injury. Common sense would dictate that
this is a most unlikely scenario, and I expect most courts would agree.
In other words, paralysis following RTA with extrication is highly likely to
have occurred as a result of the RTA, not the extrication. If the energy of
the accident was sufficient to fracture the vertebrae and rupture the
interspinous ligaments, it's hardly going to be insufficient to damage the,
now unsupported, spinal cord. And the test in civil law relies on the
balance of probabilities, so as long as the former is more likely than the
latter (>50%) then a court will find in favour of the former scenario.
Adrian Fogarty
----- Original Message -----
From: "Nick Jenkins" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, May 06, 2003 11:11 AM
Subject: pre-hospital spinal control
> Dear all,
> Imagine a hypothetical case of serious RTA resulting in neck injury with
> paralysis. Patient extricated by fire service without spinal control
> despite para-medic requests for same. Did paralysis follow RTA or
> extrication?
> There would clearly be a need for the pre-hospital providers to learn for
> the future.
> Given the pre-hospital expertise on the list how would that take place /
> what would be the lines of responsibility?
> How should it be initiated if not already done so?
> Should the hospital docs involved in treating only after the case crosses
> the hospital entrance become involved / initiate this?
> What do people think?
>
> Nick Jenkins
> A&E Consultant
> Abergavenny
> http://www.ae-nevillhall.org.uk
>
>
> --------------------------------------------------------------------------
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