I doubt few juries would actually hold the rescuer liable for acting reasonably.

The example that a person can’t be removed from a burning vehicle because of this ruling is absurd. When there is a fire, it would not be negligence to remove the injured person before stabilizing the spine. The injury to the plaintiff was not strict liability; negligence is still required.

Disclosure: I once met the plaintiff (she was in a wheelchair) at the law library and spoke to her awhile about her case.

NOTE TO THE STUPID:

The take home lesson from the below is *not* that you
should flop people with spinal injuries around like rag
dolls. DO NOT DO THAT! Regardless of the below, be
careful not to hurt people with spinal injuries.

NOTE TO THE STUPID: REREAD PREVIOUS PARAGRAPH!

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Hauswald M, Ong G, Tandberg D, Omar Z. “Out-of-hospital spinal immobilization: its effect on neurologic injury”, Acad Emerg Med 5(3):214-9, Mar 1998. PMID: 9523928

Abstract:

OBJECTIVE: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries. METHODS: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables. RESULTS: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03-3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64-3.62; p = 0.34). CONCLUSION: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

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Mark Hauswald and Darren Braude. “Spinal immobilization in trauma patients: is it really necessary?” Current Opinion in Critical Care 8(6):566-70, Dec 2002. PMID: 12454543

Abstract:

The acute management of potential spinal injuries in trauma patients is undergoing radical reassessment. Until recently, it was mandatory that nearly all trauma patients be immobilized with a back board, hard cervical collar, head restraints, and body strapping until the spine could be cleared radiologically. This practice is still recommended by many references. It is now clear that this policy subjects most patients to expensive, painful, and potentially harmful treatment for little, if any, benefit. Low-risk patients can be safely cleared clinically, even by individuals who are not physicians. Patients at high risk for spinal instability should be removed from the hard surface to avoid tissue ischemia. Understanding the rationale for these changes requires knowledge of mechanisms of injury, physiology, and biomechanics as they apply to spinal injuries.

If someone started vomiting on a backboard, they would have to be turned on their side. That would have been hard to do with one guy in the back of an ambulance! And the people really did complain until they got off of those things.

I often took immobilization devices off, after doing an exam on the neck and back to see if there were signs of tenderness, thus trauma. Too many were put on as knee-jerk responses by the ambulance staff at the scene. (But, in all honesty, they did the right thing, because of their limited training) On all of the patients that I removed the cervical collar, after a meticulous exam, no fractures were ever found on the x-rays.

I still lost my job as an ER moonlighter, in that particular hospital, because some other goon (ER doc) did not check the patient, then sent the patient to X-ray, and the collar was removed in the x-ray department on a patient with a broken neck! The head nurse thought I was the crazy one! I hope if I get into an ER situation like this, my doctor has a lot better judgment,and does his job better, than the goon!

I have too much time on my hands. I am commenting way too much! I will stop!

We need to stop suing each other. Period.

The US is crazy about spinal immobilization due to asshole lawyers. In the rest of the world they don’t go crazy about strapping people to backboards. And as a result they have LESS spinal injuries, because it’s not benign to strap someone to a backboard. It typically results in injuries, as the average time that are on the backboard is 90 minutes, and it is sometimes many hours. Try lying immobile on your back on a concrete floor for an hour and a half some time. Plus it greatly increases the chance of aspiration as you’ve made them unable to protect their airway.

If you doubt this look up “Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury. 1998″ in a good library.

I did not see anyone saying that cars do not explode (or catch fire). What was said is that they do much less frequently than one would believe by watching movie or TV accidents. This fear would cause a person, who did not know better, to think that a fire was imminent and pull an injured person away from the wreckage, which is rarely needed.

The movie example, you linked to, of such an explosion is great evidence of this. Of all the front end accidents that occur, there are not very many car fires involved. And the gas tank on the van was actually located further up the side, nearer to the front. With the low velocity and force of the accident, both vehicles would have likely been drivable, afterward, realistically, with no fire involved. But not in the movies!

Oh, not only was my dad an EMT, we also drove wreckers for many years and we witnessed only one accident that resulted in a fire. That was when, at highway speed of 65mph, a Ford Torino lost control and spun backwards running into another car (backwards head on) in the other lane, rupturing the Ford’s gas tank. Five people were burned to death in that accident, that day. Witnesses could not get them out of the burning cars. Two adults and three kids. I was about 16 at the time. We got there after the fire was out.

The government doesn’t want us helping ourselves. AT ALL. They don’t want us protecting ourselves and they don’t want us helping our neighbors in emergency situations. That’s what THEY are for. To protect us from all of the harm that can come. YOU are too stupid to do it on your own.

I’m not so sure about that. If Torti is not a licensed EMT/paramedic, nurse, physician, or a first responder such as a police officer or firefighter, how can the court expect her to understand proper protocol for removing a MVA victim from a car when she felt (rightly or wrongly) that exigent circumstances existed. Did the court expect a regular citizen in extraordinary circumstances to know precisely how to immobilize the c-spine during an emergency move? Vlad (#75) is absolutely right about how people react in these situations. No, Torti probably should not have moved the victim, but I think her actions clearly in good faith.

This is unfortunate, and it could give people pause when they see someone that needs a hand. It may also embolden those that think we have to rely solely on government agencies or “experts” during emergency situations. Voluntary action is important. You and your neighbors are the first line of defense. Police, Firefighters, EMT’s and others in protective services are the second line of defense. Poor decision, in my opinion.

http://www.youtube.com/watch?v=AScxr4nJvMc

;)

Salvo,

I agree with what you are saying BUT (there is always a but), eight states (I think: can’t find citations) do have laws about a Duty to Rescue. My google-fu has been weak on this topic. Apparently, Florida has something on the books but I’m still trying to get the specifics.

Opinion: While I generally agree that someone does not have a duty of care, I don’t think it is unreasonable to consider the possibility that in some rare (very if you like) cases, a person should be held liable for not rendering ANY aid.

This case: The facts of the case should be assessed in the courtroom. However well intentioned this girl was, she may very well have been negligent. Or not. In any case, I doubt it would have much impact on how people respond to others in an emergency.

these are ‘true emergencies’- people have to make immediate decisions, to the best of their abilities. you obviously made the right decisions- congratulations!

If they can’t move under their own power, it is usually because they have injuries that can only be made worse by yanking on their bodies.

I learned this crap in Middle School Health class – not some special course. Maybe it isn’t common knowledge, but I think it is and it definitely should be.

2. Considering how easily cars blow up on TV – a single pistol shot often being enough to blow one up – it doesn’t surprise me that ignorant people would rush to assume that a car is going to blow based on what looks like bad damage.