Leader

Collapse

Announcement

Collapse
No announcement yet.

immobilzation

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • immobilzation

    if a person falls down stairs and they move approx 20-30 ft befoe u get there do you by law still have to immobilize them in the state of wv

  • #2
    I don't know what the laws say, but just to cover you ***, c-collar, and backboard them. you'll never get in trouble for taking to many precautions. its when you don't that gets you in trouble. I know of times that we have had people up walking around when we get on scene, we took c-spine precautions and later found that they had broken vertibra.

    Comment


    • #3
      I responded on a guy that dove into a creek, walked a mile to the house. When he got to the house, he laid down and hasn't moved below the waist since. As such, I would recommend spinal immobilization on any pt. with a potential spinal injury, no matter how much they've moved around.

      Comment


      • #4
        Like one of my instructors in the past said: "Do what you know, and know what you do." In other words, if you know the MOI was a fall or high speed impact, C-spine management is a requirement.

        If it turns out that you did it and it wasn't needed, so much for the better - chalk it up to good practice. If it was required and you didn't do it...... well I hope your insurance premiums are paid up.
        If you don't do it RIGHT today, when will you have time to do it over? (Hall of Fame basketball player/coach John Wooden)

        "I may be slow, but my work is poor." Chief Dave Balding, MVFD

        "Its not Rocket Science. Just use a LITTLE imagination." (Me)

        Get it up. Get it on. Get it done!

        impossible solved cotidie. miracles postulo viginti - quattuor hora animadverto

        IACOJ member: Cheers, Play safe y'all.

        Comment


        • #5
          Now as a clinician I see it a variety of ways.

          Of course, if they move it doesn't mean squat. Is there a distracting injury? Is there a medication, drug, or EtOH on board? Was there a loss of consciousness?

          Your scenario is a bit too vague for my liking though.

          Board them if your gut tells you to, but exercise some sense and think about what is going on before you put someone on a board. Remember, skin breakdown can occur in 20 minutes in patients on a backboard. So now they have a decubitus ulcer on top of whatever injuries they may (or may not) have.
          "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

          The borrower is slave to the lender. Proverbs 22:7 - Debt free since 10/5/2009.

          "No man's life, liberty, or property are safe while the legislature is in session." - New York Judge Gideon Tucker

          "As Americans we must always remember that we all have a common enemy, an enemy that is dangerous, powerful and relentless. I refer, of course, to the federal government." - Dave Barry

          www.daveramsey.com www.clarkhoward.com www.heritage.org

          Comment


          • #6
            Originally posted by DaSharkie
            Now as a clinician I see it a variety of ways.

            Of course, if they move it doesn't mean squat. Is there a distracting injury? Is there a medication, drug, or EtOH on board? Was there a loss of consciousness?

            Your scenario is a bit too vague for my liking though.

            Board them if your gut tells you to, but exercise some sense and think about what is going on before you put someone on a board. Remember, skin breakdown can occur in 20 minutes in patients on a backboard. So now they have a decubitus ulcer on top of whatever injuries they may (or may not) have.
            Thats a new one to me! Any reason why the breakdown is so quick on a backboard? I am not advocating backboarding with "reckless abandon". Besides the hospital is usually pretty good about balling up the spider straps and yanking the BB out from under them while we are still there. (But boy do they yell when they arent boarded) (Long story, too long to get into here)
            Shawn M. Cecula
            Firefighter
            IACOJ Division of Fire and EMS

            Comment


            • #7
              Originally posted by coolmom9396
              if a person falls down stairs and they move approx 20-30 ft befoe u get there do you by law still have to immobilize them in the state of wv
              There is no "Law" regarding detailed treatment like that, but rather your department/service's protocols.

              I also agree that the movement after the fall means squat, but I'm with Sharkie. Don't board with reckless abandon. You do what your training and protocols allow. That may or may not include ruling out the need for C-spine management.

              Never argue with an Idiot. They drag you down to their level, and then beat you with experience!

              IACOJ

              Comment


              • #8
                Originally posted by Lewiston2Capt
                Thats a new one to me! Any reason why the breakdown is so quick on a backboard?
                It is strictly from the pressure. Especially prominant in the elderly folks due to loss of fat pad and subcutaneous fat. This leads to more prominent bony ridges creating more pressure. Add to that dehydration and other issues and you get a mix for nastiness. Worst case is 20 mintues for the pressure sores to set in, but even in healthy folks it can take less than an hour to do so, and you figure you are on a board at the scene for 5 minutes or so before you are transported, then another 10 - 20 minutes for transport, another 10 minutes before you get moved to a gurney (if there is one) in the ED. Another 10 minutes before you get rolled off of a board if you get cleared.

                Let alone an interfacility transport and you can add on a ton of time there too. Just something to keep in mind......

                Originally posted by Lewiston2Capt
                Besides the hospital is usually pretty good about balling up the spider straps and yanking the BB out from under them while we are still there. (But boy do they yell when they arent boarded) (Long story, too long to get into here)
                A pet peeve of mine. It may not take long to clear them before removing a patient from the board, but you realy ought to clear 'em before the straps come off. Hopefully I will not turn into that type of person when I start working.
                "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

                The borrower is slave to the lender. Proverbs 22:7 - Debt free since 10/5/2009.

                "No man's life, liberty, or property are safe while the legislature is in session." - New York Judge Gideon Tucker

                "As Americans we must always remember that we all have a common enemy, an enemy that is dangerous, powerful and relentless. I refer, of course, to the federal government." - Dave Barry

                www.daveramsey.com www.clarkhoward.com www.heritage.org

                Comment


                • #9
                  Originally posted by DaSharkie
                  A pet peeve of mine. It may not take long to clear them before removing a patient from the board, but you realy ought to clear 'em before the straps come off. Hopefully I will not turn into that type of person when I start working.
                  If you are, we'll let ya know
                  As for here...MOI, possibility of distracting injury/adrenaline rush ( the patient may not feel any pain for quite some time) and Massachusetts "liberal" protocols, this person would be boarded....
                  The comments made by me are my opinions only, not of the Fire and EMS services I am affiliated with.

                  I have lost my mind..has anyone seen it? it's not worth much..but it's mine

                  Comment


                  • #10
                    Protocol

                    In NH we have a protocol that would allow us to clear the c-spine in the filed. The pt must deny pain to the area, have no obvious deformity upon palpation, must not have any distracting injuries, be able to to move the head/neck in circles and back in forth with no demonstration of pain, and must be of sound mind, and not intoxicated.

                    Jon
                    Jon
                    FF/EMT
                    Communications Trainer
                    IACOJ

                    Comment


                    • #11
                      Originally posted by sfdffemt17
                      In NH we have a protocol that would allow us to clear the c-spine in the filed. The pt must ... and must be of sound mind, and not intoxicated.

                      Jon
                      That would rule out quite a few of our MVA patients right there!
                      Shawn M. Cecula
                      Firefighter
                      IACOJ Division of Fire and EMS

                      Comment

                      300x600 Ad Unit (In-View)

                      Collapse

                      Upper 300x250

                      Collapse

                      Taboola

                      Collapse

                      Leader

                      Collapse
                      Working...
                      X