Trauma_Dog
01-06-2000, 04:56 PM
First things first, thanks to all that responded I enjoyed hearing all of your comments. I would like to adress some of your comments and concerns and maybe clarify our policy.
This protocol came into effect due to every patient involed in a traumatic event eg..MVA, FAll ect. being placed in a collar and transported to the emergency department. Upon arrival at the ED the doctors were preforming the same evaluation (which will be included at the end) that we addopted and clearing c-spine without x-rays aprox 90% of the time.
Second, the paramedic incharge makes the call to board or not to board, if they feel uncomforable with clearence they do not call. Since this is not an automatic clearence the paramedic stills has latitude to make the call that makes him feels comfortable.
Third, the last figure we had cleared 138 patients in the field, only 12 were sent to x-ray, out of the 12 only was suspect to have a stable FX and that was suspected to be old in origin.
Fourth, studies have shown that collars and back boards cause pain, we have been on them at least once in our life, most of us could not wait to get off of them.
============================
Protocol for spinal clearnce
============================
*Pt cannot be less than 6 yrs old.
*Pt cannot have ETOH/Drug imparment.
*No decreased LOC or have had any LOC
*No spinal pain or point tenderness.
*No neuro deficit or neuro complaints.
*No destracting injuries, such as long bone Fx ect.
*Signficant MOI, eq mva w/entrapment or death of an occupant in the same vehicle ect.
*No language barrier.
Agencies oversea,like /Austalia have been doing this for 10+ years and many in the US are either doing or looking into the posiblity of implementing a simular program.
There is no substitute for a quality assessment and training in the procedure, as well as an open mind for change, my motto is if there is any questions as whether or to board or not, you probily should.
Thanks for all your comments and input again hope to hear from you soon, take care of each other.
This protocol came into effect due to every patient involed in a traumatic event eg..MVA, FAll ect. being placed in a collar and transported to the emergency department. Upon arrival at the ED the doctors were preforming the same evaluation (which will be included at the end) that we addopted and clearing c-spine without x-rays aprox 90% of the time.
Second, the paramedic incharge makes the call to board or not to board, if they feel uncomforable with clearence they do not call. Since this is not an automatic clearence the paramedic stills has latitude to make the call that makes him feels comfortable.
Third, the last figure we had cleared 138 patients in the field, only 12 were sent to x-ray, out of the 12 only was suspect to have a stable FX and that was suspected to be old in origin.
Fourth, studies have shown that collars and back boards cause pain, we have been on them at least once in our life, most of us could not wait to get off of them.
============================
Protocol for spinal clearnce
============================
*Pt cannot be less than 6 yrs old.
*Pt cannot have ETOH/Drug imparment.
*No decreased LOC or have had any LOC
*No spinal pain or point tenderness.
*No neuro deficit or neuro complaints.
*No destracting injuries, such as long bone Fx ect.
*Signficant MOI, eq mva w/entrapment or death of an occupant in the same vehicle ect.
*No language barrier.
Agencies oversea,like /Austalia have been doing this for 10+ years and many in the US are either doing or looking into the posiblity of implementing a simular program.
There is no substitute for a quality assessment and training in the procedure, as well as an open mind for change, my motto is if there is any questions as whether or to board or not, you probily should.
Thanks for all your comments and input again hope to hear from you soon, take care of each other.