Steve
Mostly Harmless
I don't know. I'm not a medical professional. You're probably right about what happened after the injury. However, I stand by my assessment of what happened before the injury.
Broken neck in BJJ Tournament (OUCH)
- Thread starter 1Ganger
- Start date
I'm not a medical "professional" either, but it's pretty basic-the kid should have been evaluated (asked questions and to perform), and then collared and boarded for transport. Odds are good (having no knowledge of the state of emergency response in Brazil) that he was collared and boarded for transport, but it might have been too late, because the ref turned him over.
Steve
Mostly Harmless
yeah, that sucks, and I don't doubt you're right.
I don't know whether the referees at our local tournament have any medical training. I certainly don't. But we do have three medical professionals on site, standing by for injuries. I don't know for sure, but I think one is an EMT and the other two are RNs. They are also jits practitioners, so they're pretty familiar with the types of injuries that could occur.
I don't know whether the referees at our local tournament have any medical training. I certainly don't. But we do have three medical professionals on site, standing by for injuries. I don't know for sure, but I think one is an EMT and the other two are RNs. They are also jits practitioners, so they're pretty familiar with the types of injuries that could occur.
Again, because I'm advocating medical training for refs, at a minimum all referees should receive regular medical briefings from the professionals on site as to what they should and shouldn't be doing under certain circumstances where the possibility of injury is higher-like this one.
I mean, he knew to stop things-it's most likely under those circumstances that the injury wasn't a broken ankle, and there's a protocol for cervical injuries that can mean the difference between six months of rehab and a lifetime in a wheelchair.
I have to agree Elder999.
Steve,
It is good that they have addressed the issue of underage competitors competing against adults. While that cannot undue what happened it is a good start to making sure that things are on an even playing field for future athletes.
Steve,
It is good that they have addressed the issue of underage competitors competing against adults. While that cannot undue what happened it is a good start to making sure that things are on an even playing field for future athletes.
Not sure that I completely agree that he shouldn't have rolled the kid. He had to do something to ensure an airway and to assess. But since it was clear that a spinal injury was possible, he should have been rolled in a way to protect the spine rather than simply flipped. And if EMTs or other equivalently trained personnel were available, they should have been the ones to do it.
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Nah-there's rolling him over, and then there's what the ref did. One would be correct, in the "first do no harm" kind of way, and the other would be the way he did it, in the "here's what you don't do" kind of way.
I think I qualify as a professional...
It's pretty widely accepted among the medical community that there is no real benefit to collars and boards. We do them because people expect it to be done. And protocols are changing to do away with them in most cases. In a few years, it will be very rare to see someone collared and boarded.
The only benefit to boarding someone is that it makes it easier to move them.
Do a literature search for cases of boney spinal injury without neurological deficits that later developed cord injury.
It won't take you long at all to read every single case history.
If the impact didn't damage the cord, it is extremely unlikely that rolling him over did.
I can provide a more detailed answer, if people are interested, when I'm not on my phone.
Sent from an old fashioned 300 baud acoustic modem by whistling into the handset. Not TapaTalk. Really.
Interesting! I'd love to hear more details on current best practices.
The short version is: they don't really do diddly.
C Collars and backboards do not keep the spine in a neutral position. It ain't straight...
Here's a few artiicles:
Prehospital Spinal Immobilization EMSWorld.com
Why EMS Should Limit the Use of Rigid Cervical Collars - Journal of Emergency Medical Services
Research Suggests Time for Change in Prehospital Spinal Immobilization - Journal of Emergency Medical Services
Ditch the Spine Board
http://www.acphd.org/media/311913/santa cruz- new thinking about spine injures.pdf
The only real reasons collars and boards are still being routinely used is cultural inertia ("that's how we've always done it!") and fear of lawsuits (since the general public "knows" this should be done).
Zero
Master Black Belt
Look, I totally agree with you here Elder!! No way anyone like that should be rolled/moved, and absolutely any ref in a physical competition environment, from rugby to contact fighting/wrestling, should know not to roll in that scenario. You can have a feather/hairline break or be on the cusp of this and by moving un-stabilised you complete the fracture and actually complete on the paralysis.
Am not a medical professional either but did three years as a volunteer fire fighter and first thing we were trained on coming across potential neck injuries was not to move until they have been fully assessed and/or braced. When faced with a bad car accident with potential inflammables, it is always an issue of having the time to assess and how appropriately and safely to move and stabilise the victim versus getting the victim and yourself of out of the vehicle.
This is not really true, but if you didn't bother to read the explanation and links above the first time, there's no real sense in going through it all again.
Steve
Mostly Harmless
Happens all the time, and a good reminder that just because we learned something once doesn't mean that it's really true. Particularly in the sciences.
Staying current isn't easy. It's a rare day when I'm not reading or viewing something to stay current.
Zero
Master Black Belt
Hey, I read through on the freeing of airways and totally agree with that, if it is done right and appropriately - if there is the risk of such.
Gotta admit I have not had the time to chew through all your links on the neck-board and brace collar "myths" (hmmm), it's a mix of spending some time on MT and having a real (not virtual life) and making money to pay bills...but I will go over those links, as they look like very good reading, so thanks for those!
Again I am no Doc but can totally understand the thoughts as to doing away with spinal boards - for the curvature of the spine, for sure...Not so sure, in my ignorant position, as to losing the neck collar though. I still come from it is better to brace before any movement so to prevent further damage, I don't understand how that no longer applies??...but let me read through your links...
Also not overly keen on your use of "that is really not true". I do have a science background and use my geology (in a limited sense) on a lot of the projects I do. In my own short time I have seen scientific "truths" disproven or replaced, plate tectonics for a start.
The same also applies to the fields of medicine and trauma treatment, plenty "old school" medical approaches been thrown in the bin, some even looked at in horror now, whose to say there won't be an informed "flip" on these current views as to collars?
Think of it this way. If I stab you, you've got a problem. But if I just put the knife against your skin, it's no big deal.
That doesn't mean that it's not good to be cautious. It just means that the panic stricken cries of "DON'T MOVE!!!!!" are not really necessary.
That doesn't mean that it's not good to be cautious. It just means that the panic stricken cries of "DON'T MOVE!!!!!" are not really necessary.
Zero
Master Black Belt
I've read through those links now, thanks, although I think I need to do a lot more reading on this.
I see soft-collars are not argued against for the same reasoning as to rigid collars.
In addition, a lot of this "new" approach is based on the ability to be able to effectively assess the victim. The statement in paper/link #2, a victim "not requiring imaging does not require immobilisation" is not exactly helpful.
Again I am no doctor or medical professional and it was few years back now when I was a fireman but a lot of our work was attending as first responder to car crashes on coastal roads. There is not always the ability or luxury to wait for ambulance crew on these calls. As a fireman I was of course given on-going medical training but nothing to the level of an ambulance crew or other forms of EMS. I can confidently say, no one in my brigade had the ability to make those kind of assessments regarding spinal injuries or complex trauma. If we could not wait for the ambulance and the victim was unconscious or otherwise could not communicate and there looked to be the risk of spinal damage, we braced with collars, on the "this is better than the alternative" approach. There were limited opportunities to be even able to have the space to use a board so this didn't really apply, just the collar. I cannot see how this position can change, unless fireman are now given additional extensive first aid/EMS training, which I do not think they are.
I totally understand and appreciate your comments on this. It is also logical to see how the boards or even more so, any form of collar, can adequately protect against all angles of movement. But not sure if this applies as a universal approach or for non-EMS not able to make these kind of assessments...don't you think?
Ironbear24
Senior Master
Why? From the sound of it and from what I have seen you know a lot and do well.
