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February 15, 1985

Emergency Medicine-Reply

Author Affiliations

Porter Memorial Hospital Valparaiso, Ind

JAMA. 1985;253(7):981. doi:10.1001/jama.1985.03350310063022

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In Reply.—  Being versed in the dogma of the American College of Surgeons as it relates to the cervical spine and its priority in trauma patients, I feel that Emergency Medicine fails to convey the proper current approach to patient management in this vital area of patient care. In chapter 12, "The Critically Injured Patient," patient assessment is described as "note if the spinal cord is in danger." Assessment of the patient's dorsum is accomplished utilizing a log-rolling maneuver "while someone supports the head and neck...." Later in the chapter when a cervical spine injury is suspected, "the neck should be splinted with sandbags." Later inhospital discussions of cervical injuries, in particular, address the use of cervical tongs, without mentioning other initial stabilization techniques.Standard aspects of current early management, such as a rigid cervical collar, in-line axial traction by attendant, or simply stationing a person to literally hold the