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A study in the Journal of Trauma & Acute Care Surgery (2012;73:498–502) suggests that the concept of ‘distracting injury’ in cervical spine clinical clearance in awake (Glasgow Coma Scale 14 or 15) and alert blunt trauma patients is a non-entity. This contrasts with traditional Advanced Trauma Life Support guidelines which advocate the preclusion of cervical spine examination in the presence of ‘distracting injuries’, especially considering that there is often confusion around this term. They found the sensitivity of clinical examination alone was 99% for the identification of cervical spine injury and felt radiological assessment was unnecessary in safe clearance of the asymptomatic cervical spine, offering a potential reduction on healthcare cost and radiation exposure.
Power and conflict
The effect of teamwork on team performance is broadly recognised in the medical field, and nowhere is this more apparent than in the Emergency Department (ED). The characteristics of ‘medical action teams’ give rise to all kinds of issues of disagreement and are accompanied by complex issues of intra-team power distribution. How members coordinate, cooperate and communicate is steered by members’ personal motivations, …
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