It seems that logical fallacies run deep in EMS, and not just the appeals to tradition as we most frequently see. Some are also appeals to common practice (which could be seen as an appeal to tradition), appeal to consequences, and a number of other distortions or ignorance of fact or truth or creation of the legal “boogey man”.
Let’s take spinal immobilization as an example. There is no evidence supporting or denying that spinal immobilization has any long term benefit, or any benefits at all for that matter. Research simply can not say it helps or hurts. This is for a few reasons. It falls to several logical fallacies as to why no one wants to steh long term effects. Mainly it falls to appeals to common practice and appeals to consequences (creating the legal boogey man) because we have been doing it for so long out of fear of a lawsuit that we dare not do it. This is an example of a fallacy. It may even fall to a few others, but there are so many different arguments that I don’t want to get carried away. It’s a little amusing to me that patients still show up in emergency rooms on backboards simply because they were in a car that was involved in any crash, despite physical evidence (and proven research) to the contrary that one was even needed. EMS providers can perform a proper assessment will increase suspicion of the need for a backboard. Read the NEXUS study or the multiple articles about the Maine Spinal Clearance Algorithm. It will open your eyes.
Another one I have been focusing on recently has been Dextrose 50%. Despite excellent research and even economic factors, we continue to use D50 even though it has been proven to cause more severe blood sugar spikes in hypoglycemia patients resulting in longer hospital stays and worse outcomes. Research has shown that alterntives like D10 and equivalent doses of D5 contain the same amount of dextrose as the 50mL D50 vials and can be delivered with more patient safety and better long term outcomes. When we administer dextrose as a drip instead of a massive bolus, we can titrate the flow rate and effect to the patient and give the body just the amount it needs to regain and maintain proper brain function. This results in less severe blood sugar spikes, shorter hospital stays, and possibly much better longer term outcomes. This better line of thinking falls to appeals to tradition, “we’ve always used D50.” Yeah, this is true, but when faced with something proven better, it makes more sense to switch when it is both safer, just as if not more effective at producing better outcomes, and not to mention cheaper. You can buy a case of D5 in the 500 mL bags for the price of 2 or 3 of the D50 50mL vials.
So how can you avoid these fallacies in discussions with your crew mates and co-workers? Keep well read. The journals and magazines always have solid foundations in research when written, and this will give you some evidence to go on when someone presents you with an argument and keep you from falling into using a logical fallacy to defend or present an argument.