This article is about ten years old, but it’s still relevant.
Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials
Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
Design Systematic review of randomised controlled trials.
Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.
Study selection: Studies showing the effects of using a parachute during free fall.
Main outcome measure Death or major trauma, defined as an injury severity score > 15.
Results We were unable to identify any randomised controlled trials of parachute intervention.
Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.
As the saying goes, read the whole thing.
Keep in mind that the British Medical Journal is a real publication and a serious one at that. It’s not the Journal of Iatrogenic Medicine*, so you can trust it for the most part. A friend of mine who reads the BMJ regularly assures me that this article was in fact peer reviewed before it was published. The references are real, I clicked on them to be certain. Another friend who spends a lot of time teaching fellows who jump out of perfectly good aircraft all too often, tells me that he uses this in his classes. The guys get a kick out of it when they are discussing EBM.
A call to (broken) arms
Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.
The authors point is valid. Not everything we do in medicine or EMS has a lot of science behind it. Sometimes we have good evidence, but sometimes we don’t have good evidence and yet a procedure or technique seems to work.
I can’t wait for Rogue Medics 73 part, multicolor, 17 font, rebuttal.