Who's still routinely c-spining?

[Novice001]

C-spining

It's true most BLS medics use C-spine. It's pretty much what I was taught. However, when it comes to traumatic injuries i.e. MVA, crush injuries, falling from a height, head injuries etc. I would still use C-spine. You need to take into account the MOI. Pts in a car accident need to have a cervical collar and put on a backboard or other types of immobilization equipment.

 

[chaz90]

It's true most BLS medics use C-spine. It's pretty much what I was taught. However, when it comes to traumatic injuries i.e. MVA, crush injuries, falling from a height, head injuries etc. I would still use C-spine. You need to take into account the MOI. Pts in a car accident need to have a cervical collar and put on a backboard or other types of immobilization equipment.

Please oh please read the rest of this thread before chiming in here. Catch up on the current research a little bit. It likely isn't best practice to use SMR on anyone, let alone the incredibly broad patient population you're describing. MOI is also increasingly being deemphasized as unreliable with extremely poor predictive value for injury or mortality. Your last sentence is alarmingly inaccurate. No immobilization of any kind is necessary in the vast majority of MVAs.

 

[Medic Tim]

It's true most BLS medics use C-spine. It's pretty much what I was taught. However, when it comes to traumatic injuries i.e. MVA, crush injuries, falling from a height, head injuries etc. I would still use C-spine. You need to take into account the MOI. Pts in a car accident need to have a cervical collar and put on a backboard or other types of immobilization equipment.

just because you learn something in school or it is a current protocol does not mean it is the right thing to do. there is a ton of research out there on smr. it has been there for a while. We are just now seeing the wave of change.
at my current service I am still supposed to collar and board most pts but If I can... I don't.

there are several threads here on this subject. I hope you look at it or do some digging in your own.

 

[Novice001]

C-spining

Thanks for the input, guys. Much appreciate it. However, I would like to remind you things are different here in SA than what they are in the States.

 

[Tigger]

Thanks for the input, guys. Much appreciate it. However, I would like to remind you things are different here in SA than what they are in the States.

I'll give you that protocols might differ from place to place, but the human body does not.

 

[Medic Tim]

Thanks for the input, guys. Much appreciate it. However, I would like to remind you things are different here in SA than what they are in the States.

That is true ... But it doesn't change the data and research. Hopefully your system is open to change and evidence based practice.

This isn't just a USA thing either. It is being done in several countries across the world. My service in Canada is looking into it as well.
Do the field medics there have an avenue for protocol suggestions or changes?

 

[WildlandEMT89]

My department has just switched from full c-spine every time to a new Spinal Motion Restriction (SMR) protocol in the last month or so.
Our new protocol allows us to intervene on a sliding scale based on the severity of the incident ,pt risk factors (age/MOI) and if several factors are cleared in the field (distal function/ no evidence of severe spinal trauma). The goal is to maintain proper pt care while still giving the pt some level of comfort if possible.

 

[brian328]

i am a basic and our protocol follows the acronym "NSAIDS". if they fail any one of exams, they get boarded. i do think this will be changed in the future..

 

[jboz7089]

rural AK

Hey everyone,

New member here. I live in rural AK on an island that flourishes due to the fishing industry. We routinely have to use a backboard, or a Reeves sleeve to transport our patients due to the close quarters of fishing vessels. The Reeves sleeve also allows us to hook into the boats crane, and lift the patient off the vessel, rather then trying to hall them up the steep stairs. Typically, we don't C-collar the patient, unless absolutely necessary.

 

[Bullets]

Hey everyone,

New member here. I live in rural AK on an island that flourishes due to the fishing industry. We routinely have to use a backboard, or a Reeves sleeve to transport our patients due to the close quarters of fishing vessels. The Reeves sleeve also allows us to hook into the boats crane, and lift the patient off the vessel, rather then trying to hall them up the steep stairs. Typically, we don't C-collar the patient, unless absolutely necessary.

And you wont find anyone here chiding you for using the LBB as intended, a tool for extrication and movement.

 

[Handsome Robb]

What he said ^^^^

 

[mflaws]

cspine

I took a recent trauma class and a lot of what i have been hearing is that c collaring and backboarding people is cause more damage to them then good. Also ive noticed a lot of people are having slight trouble calming down enough to measure and apply everything in the correct manor. Also some people dont relise when we strap people down really tight to the board some peoples lower back does not even touch the board so we are forcing people into uncomfortable positions. What is everybodys thought?

 

[chaz90]

I took a recent trauma class and a lot of what i have been hearing is that c collaring and backboarding people is cause more damage to them then good.

Yep. That's the point of the rest of this thread.

 

[Kevinf]

Plenty of backboarding going on over here:

 

[mfd229]

Our protocols have not changed yet, although they are being reviewed. We routinely backboard patients with suspected injury. Our transports are short however and have a relatively low risk of further injury by being on a backboard for too long.

 

[Streetdoc]

I saw a BLS crew do a standing take down the other day. I just shook my head.

They not only still teach it here, but I have seen a few FF/EMT's try to do it to someone who is standing, JUST so they could do it. Any other time, they are all "short of breath? Okay, lets walk out to the unit".:wacko:

 

[ILemt]

The trauma centers in this area require that all patients transported for a Fall, MVA, GSW, or Syncope MUST be wheeled into the ER with complete spinals, cardiac monitor, pulse ox, o2, finger stick bgs, and at least 1 large bore in place. Selective criteria while officially "in the protocol book" is only allowed with on-line direction which is given almost as often as orders for an EMS pericardialcentesis.

 

[chaz90]

The trauma centers in this area require that all patients transported for a Fall, MVA, GSW, or Syncope MUST be wheeled into the ER with complete spinals, cardiac monitor, pulse ox, o2, finger stick bgs, and at least 1 large bore in place. Selective criteria while officially "in the protocol book" is only allowed with on-line direction which is given almost as often as orders for an EMS pericardialcentesis.

These are some of the most idiotic requirements I've ever seen. Spinal immobilization for penetrating trauma? Large bore IV for all falls? Utterly ridiculous.

 

[Handsome Robb]

The trauma centers in this area require that all patients transported for a Fall, MVA, GSW, or Syncope MUST be wheeled into the ER with complete spinals, cardiac monitor, pulse ox, o2, finger stick bgs, and at least 1 large bore in place. Selective criteria while officially "in the protocol book" is only allowed with on-line direction which is given almost as often as orders for an EMS pericardialcentesis.

Wow.

The 90s called they want their medicine back.

 

[Handsome Robb]

I guess the 00s too