Defensive EMS practice

From the comments to this July 30 post at KevinMD about defensive medicine: “Spreading to paramedics?” Doc, it’s been prevalent in EMS for years. Virtually every EMS system in this country is designed specifically to serve less than 1% of its run volume – cardiac arrest patients. We continue to spinally immobilize (now there’s a […]

From the comments to this July 30 post at KevinMD about defensive medicine:

“Spreading to paramedics?”

Doc, it’s been prevalent in EMS for years. Virtually every EMS system in this country is designed specifically to serve less than 1% of its run volume – cardiac arrest patients.

We continue to spinally immobilize (now there’s a misnomer!) trauma patients, despite the evidence that clinical exam criteria can safely clear these patients and other evidence that questions whether pre-hospital spinal immobilization is even beneficial.

We fly people on helicopters based on nothing more than mechanism of injury, despite the mounting number of fatal crashes and the fact that 95% of those patients flown to the ED were discharged home directly from the ED. That’s right – we flew them on a $10,000 flight, and they weren’t even sick enough to be admitted.

Prehospital care is a bastion of defensive medicine. Has been for some time.

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