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On a Roll & the Role of Rollovers

On a Roll

Thom Dick really struck a chord when he revisited a time-tested technique for extricating difficult-to-lift patients in July Tricks of the Trade. One reader wrote to say her husband invented the "Montana Blanket Roll," while a veteran EMSer also answered Thom_s call for information about how this trick came about.„

The exact genesis of the "Montana Blanket Roll" is not absolutely certain. However, it was institutionalized during the development of the Critical Trauma Care for the Basic EMT course in Montana in the mid-1980s (where it was called the "Montana Horse Collar") as a rapid extrication technique for auto crash victims with life-threatening conditions. The primary authors on that curriculum were Joe Hansen, Nancy Rahm and myself, although, admittedly and gratefully, we had a lot of input from very dedicated EMS providers around the state. By the way,I still teach this technique todaysince I haven_t found anything better for removal of a patient in a minute or two in the presence of an uncontrollable airway, bleeding or an external threat.

Nels D. Sanddal,„MS, REMT-P

Bozeman, Montana

To my knowledge,my husband ("Wild Bill" Tidwell) invented this "roll"about 20 years ago. He calls it a "Montana Horse Collar." We teach CPR and Wilderness First Aid all over the northwestern states and have taught this "collar" for lifting and moving patients. Good article; glad to know [the collar] has been passed along.„

Louise Tidwell

Kalispell, Montana

The Role of Rollovers

Your August cover shows a vehicle on its roof and makes a statement under the headline that says, "Suspended Trauma: How rollovers and harnesses can later kill rescued patients." This is misleading, especially because the new CDC/NHTSA nationally accepted triage scheme has removed rollovers with restrained occupants from mechanisms of concern because there_s no evidence that they consistently result in serious injuries.

Ed D. in PA

Editor-in-Chief A.J. Heightman responds:We did not mean to infer that rollovers alone would be the direct cause of deaths. We were attempting to point out that people trapped in difficult locations and positions, particularly those trapped or left in place for a long time, could result in suspension trauma. Unfortunately, we did not reference cases of this nature in the article, but felt that it could be inferred by Bill Raynovich_s thorough review of the physiology of suspension trauma. The reality is that the vast amount of restrained rollovers are "uncomplicated," not really representing suspension trauma.

CORRECTION

In May 2008 Hands On, an incorrect image was shown for ML Kishigo_s 1166 and 1167 4-Season Ultra-Cool Mesh Vests. Visitjems.com/Kishigoto see the correct image.JEMS



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