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Showing Tag: "injury" (Show all posts)

Cervical collars and spinal cord injury protection

Posted by Matthew Mac Partlin on Friday, June 14, 2024, In : Clinical topics 


It’s not a black and white choice of collar or not, good or bad, routine or never.

 In the setting of an actual or probable cervical spine injury, providing stability control is widely accepted as better than providing no stabilization at all. It is then an issue of how best to provide that stability control.

The choice is dynamic, not “set and forget”. Two things are important in making one’s choice:
  • Being able to justify the choice based on a sound assessment of the evidence and how it...

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Ankle injuries - A good review on the Emergency Medicine Case site

Posted by Matthew Mac Partlin on Wednesday, July 4, 2018, In : Clinical topics 


The ankle joint was one of the last things I studied in anatomy waaaay back in university; probably in First or Second Med. It seemed to be a victim of priority and as a result was never studied that well. Yet we see 'sprained' ankles all the time in the ED and there is a goodly proportion of them that end up in the circuit medical centre. 

Often it's an official who has rolled their ankle while accessing or leaving their track position. Sometimes someone has gone over in the paddock. It might...

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Renal tract trauma

Posted by Matthew Mac Partlin on Thursday, August 10, 2017, In : Clinical topics 

You've picked up a competitor from the track following a collision that occurred on the exit of a high speed turn. He's now at the medical centre and has begun to complain of flank pain. He's certainly pretty tender over his right lower ribs posteriorly and on further examinations there's a little bit of blood where wee usually comes out.

Eeek! He might have blunt renal tract trauma.

Luckily, you've just been to this website and read through the material below. Having taken care of the core res...

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ICMS AGM 2016 - Intro and Day 1

Posted by Matthew Mac Partlin on Friday, February 24, 2017, In : Conferences, courses & events 

This conference was great. It was what a motorsport conference covering safety, medical and rescue issues should be. No topic was off limits, no presenter was protected from being challenged (and most audience challenges stuck to the rules of engagement), invited speakers were from a broad range of backgrounds (gender, profession, motorsport category and geography) and most appealing of all, there was a general air of desire to promote and progress improved understanding and practice.


(I don't...

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A tonic for the C-spine collar haterade

Posted by Matthew Mac Partlin on Friday, February 24, 2017, In : Conferences, courses & events 

I've been drinking from that fountain. Semi rigid c-spine collars have been receiving a drubbing in recent times (Search the c-spine collar tag over to the right of this page). And with good reason, I thought; though I will admit to not being quite ready to throw them away completely as I have been a long time practicioner of avoiding the "always/never" ultimatum.


Then trauma master, Karim Brohi, Professor of Trauma Sciences at Barts and the London School of Medicine, and Consultant in Trauma...

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The crushing weight of evidence

Posted by Matthew Mac Partlin on Wednesday, September 21, 2016, In : Clinical topics 
It's interesting how things sometimes seem to come together at the same time for different reasons. I've been thinking about extrication recently in the setting of a competitor trapped by compression. That got me thinking about a talk given by Sydney HEMS doctor, Cliff Reid, titled "The wrong stuff" during which he went through some pre-hospital dogma bug-bears (bug-dogs?), including the management of crush injury/syndrome. At the same time of my pondering a tweet went out for a doctor in Ita...

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Article review - Concussion

Posted by Matthew Mac Partlin on Friday, May 8, 2015, In : Clinical topics 


Concussion has been a big topic over the past two years or so and it has certainly featured in a couple of posts on this website. There is a lot about it that is still poorly understood.
  • What is the pathophysiology?
  • Does second impact syndrome really exist?
  • Does chronic traumatic encephalopathy really exist?
  • What is the best marker of readiness to return to active competition?
There is a very helpful review article in the Seminars in Neurology journal written by Meeryo, Chloe and Giza, titled "Dia...

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C-spine collar glory days

Posted by Matthew Mac Partlin on Wednesday, May 21, 2014, In : Clinical topics 


Sorry about this. I had planned to put up a post on the devolving role of the semi-rigid cervical spine collar two weeks ago. However, the more I read about it, the more I wrote and I ended up with a five page document. Waaay too long for a blog post!

So what I'm going to do instead is submit the original piece to a journal as an opinion piece and see if I can get it published. If that happens I'll put up a link to the article. In the meantime, as it may take some time to get through the edito...

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Time for a Registry

Posted by Matthew Mac Partlin on Sunday, January 19, 2014, In : Musings and opinion 
Posted by Matthew Mac Partlin on Friday, October 25, 2013



It’s hard to know that a problem exists if you don’t look for it.

Sometimes you’ll find it because the problem finds you, usually through an adverse outcome. But wouldn’t it be better to know of  a potential problem’s existence beforehand and, even better, put something in place to mitigate it. So it makes sense to look out for problems before they cause trouble; that’s just basic survival.

And it is not without ...

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Trauma coagulopathy & Head and Spinal injury prediction

Posted by Matthew Mac Partlin on Saturday, January 18, 2014, In : Clinical topics 
Posted by Matthew Mac Partlin on Wednesday, August 1, 2012

If you keep an eye on some of the great critical care blog sites, at some point you will have come accross Cliff Reid's Resus M.E. site. Recently he has put up 2 great posts that should be of interest to all of us who practice medicine and rescue in motor sports.

The first is a presentation given by HEMS doctor, Pete Sherren, on the bleeding trauma patient. He outlines an illustrative pre-hospital case and follows through to the ICU ad...
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Continuing after concussion

Posted by Matthew Mac Partlin on Saturday, January 18, 2014, In : Clinical topics 
Posted by Matthew Mac Partlin on Thursday, April 26, 2012

I caught up with the IRC Series recently and watched the Circuit of Ireland event on wrcforeva's YouTube channel. If you watch "IRC 2012 Circuit of Ireland - Day 2 Highlights" at about 17:54 on the timeline, Andreas Mikkelsen has a high speed side impact with a haybale barrier on the short Lisburn stage.



The commentator states that Mikkelsen lost 40 seconds on the stage and complained of "dizziness". It is suggested that he sustained a ...
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Fluid type in volume resuscitation

Posted by Matthew Mac Partlin on Saturday, January 18, 2014, In : Clinical topics 
Posted by Matthew Mac Partlin on Friday, March 9, 2012

The European Society of Intensive Care Medicine recently issued a consensus statement on volume therapy in critically ill patients , in which they make 10 recommendations in all, based on the GRADE system. Of interest to the motorsport medical community is their recommendations on choice of fluid for trauma, traumatic brain injury and burns.

Recommendation 4 states that albumin and synthetic colloids (e.g. gelofusin, hydroxyethyl starch) s...
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The value add of hard c-spine collars

Posted by Matthew Mac Partlin on Saturday, January 18, 2014, In : Clinical topics 
Posted by Matthew Mac Partlin on Monday, February 27, 2012

Courtesy of Cliff Reid's Resus.ME blog, here's an interesting article (Emerg Med J. 2012 Feb;29(2):104-7) that questions the added value of applying a hard c-spine collar to a trauma victim who is already secured on a spine board with head blocks and strapping. Balanced against the apparent lack of benefit is the potential for harm due to a greater limitation of mouth opening while a hard collar is in situ; though conventional practice...
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