# Spinal Injury Trampoline Extrication



## Shelby Stotts (Mar 13, 2018)

Hi all!

Recently during a CE course the instructor told a story of having to extricate someone from a trampoline who had fallen on their neck and was experiencing tingling and numbness in the limbs. How would you handle this situation? It would be difficult to get enough people on the trampoline to log roll the pt. without the trampoline collapsing. The instructor didn’t specify how they did it. But said they considered using a basket on a heli. Thanks!


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## VFlutter (Mar 13, 2018)

A basket on a helicopter.....Ya, no.


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## VentMonkey (Mar 13, 2018)

Shelby Stotts said:


> How would you handle this situation?


Very carefully. An absolute take your time scenario.

Seriously, with the high index of suspicion for a true SCI, I’m sure as many hands on deck to move the patient safely off of the trampoline without the ridiculously wasteful resource of a helicopter hoist rescue would be sufficient.

Just out of curiosity, was this instructor a fyreMAN-medic?


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## PotatoMedic (Mar 13, 2018)

Know that there will be some movement but the major inhury has occurred and that the patient is usually self splinting well.  I would just send three people.  One to place a c collar and hold the head.  And the other to to place a clam shell/scoop stretcher to extricate the patient.  Then place them on my gurney and removed the clamshell and transport to the ER with a possible SCI.  But that is also working with my spinal protocols.  

Also to note once the person is on the clamshell i can send more people to help drag the person off the trampoline or whatever.


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## DesertMedic66 (Mar 13, 2018)

Depending on how tall the trampoline is you could possibly slide the gurney under it and raise it up (if you have a powered one) under the patient. That would cause the part of the trampoline where the patient is to be stable and would provide support as you move the patient to whatever device your agency approves. 

Please don’t use a helicopter for that


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## Peak (Mar 13, 2018)

Yeah, I'm gonna vote no helicopter.

How worried am I about musculoskeletal injury? Without serious risk factors the patient most likely hyperflexed their neck and stretched their spinal cord without bone or ligament involvement. I would place a C-collar on the patient and then use a scoop (which is over kill but keeps that license intact) to move them to the cot for transport.

I like @DesertMedic66 idea of the power stretcher. Depending on the construction type and surroundings you could potentially use fire to lift the trampoline, remove the legs, and then lower the trampoline to the ground. Or just be careful and accept the fact that emergencies happen in austere conditions and that a perfect extrication may not be possible.


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## Akulahawk (Mar 13, 2018)

These days I'd suggest, as @DesertMedic66 suggests, use a power cot under the trampoline to support the patient. The hard part is how to very slowly put a c-collar on the patient first without causing too much movement. If you can't do that, then just proceed very slowly to minimize movement. Once both are in place, just cut the trampoline around the patient and lower the patient down and out from under the trampoline. If gaining access under the trampoline isn't possible, then the next best option is a c-collar and scoop stretcher to extricate the patient off the trampoline. 

As far as MSK injury goes, I would also be worried about posterior neck ligament tears from hyperflexion which could stretch the spinal cord, causing microtears there. In any case, the key thing is being very smooth while working slowly and deliberately around and on the trampoline. The situation and available equipment would basically dictate the specific response necessary.


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## Tigger (Mar 13, 2018)

How would using a helicopter even help...you still have to put the patient in the litter.


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## PotatoMedic (Mar 13, 2018)

And I just ran a call for a person injured on a trampoline.


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## VFlutter (Mar 13, 2018)

PotatoMedic said:


> And I just ran a call for a person injured on a trampoline.



Did you call for a helicopter?!


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## PotatoMedic (Mar 13, 2018)

VFlutter said:


> Did you call for a helicopter?!


I thought about it... But was told no go due to weather.


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## DrParasite (Mar 14, 2018)

Shelby Stotts said:


> But said they considered using a basket on a heli.


So was he calling for the helicopter simply for the basket?  because many FDs have stokes baskets on their heavy rescues.  or was he calling for the helicopter to lower their the basket to lift the person off the trampoline?  which sounds like a really really bad idea, and a huge waste of resources.... but it would look awesome on the news.

thinking of the giant indoor trampoline parks (which are popping up everywhere), this idea doesn't seem farfatched, or that complicated.  walk on the edges of the trampoline (they typically don't bounce), and walk to the closest edge to the patient.  thank slowly and carefully walk to the patient on the bouncing part.  if you want to minimize bounce, slide to the person until someone can stabilize the patient manually, then slide the board to that person and have the other two go assist.

or even better, take 2 LSB, put one from the edge to the patient, walking on it to minimize the bouncing.  use second board to secure patient.  once secured, carry off.  try not to drop the patient.


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## Shelby Stotts (Mar 18, 2018)

VFlutter said:


> A basket on a helicopter.....Ya, no.


That was my thoughts, lol. I think he may have been a bad joke teller.


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## Shelby Stotts (Mar 18, 2018)

VentMonkey said:


> Very carefully. An absolute take your time scenario.
> 
> Seriously, with the high index of suspicion for a true SCI, I’m sure as many hands on deck to move the patient safely off of the trampoline without the ridiculously wasteful resource of a helicopter hoist rescue would be sufficient.
> 
> Just out of curiosity, was this instructor a fyreMAN-medic?



Thanks for the reply! And yes, he was certainly more MAN than MEDIC


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## Shelby Stotts (Mar 18, 2018)

PotatoMedic said:


> Know that there will be some movement but the major inhury has occurred and that the patient is usually self splinting well.  I would just send three people.  One to place a c collar and hold the head.  And the other to to place a clam shell/scoop stretcher to extricate the patient.  Then place them on my gurney and removed the clamshell and transport to the ER with a possible SCI.  But that is also working with my spinal protocols.
> 
> Also to note once the person is on the clamshell i can send more people to help drag the person off the trampoline or whatever.


Thanks for the reply! Was very interested to hear thoughts on this. I'm a new EMT and my class basically never used a scoop stretcher, the instructors weren't the _best._


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## Shelby Stotts (Mar 18, 2018)

DesertMedic66 said:


> Depending on how tall the trampoline is you could possibly slide the gurney under it and raise it up (if you have a powered one) under the patient. That would cause the part of the trampoline where the patient is to be stable and would provide support as you move the patient to whatever device your agency approves.
> 
> Please don’t use a helicopter for that


Yeah I agree I think the helicopter was either a poorly executed joke or a PR stunt.


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## johnrsemt (Apr 10, 2018)

roll the power stretcher under the patient, raise the stretcher until the pt. is being supported by it, then cut the trampoline matt around the stretcher, lower the stretcher and C-Collar the pt. and lower the stretcher and roll the cot out from under the trampoline.

Had one 15 years ago or so:  older trampoline that hadn't been used and was dry rotted.  1st time a 19 year old jumped on it,  after 2 bounces both legs went through the mat, broke when the hit the ground,  when we arrived he was standing up, half supported by the matt, and everytime the trampoline moved his broken legs would bounce against the ground.  That was fun


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## E tank (Apr 10, 2018)

Shelby Stotts said:


> But said they considered using a basket on a heli. Thanks!




Back a ladder truck in, have three guys hang off the bucket, scoop the patient with the c collar and lift him off the trampoline with straps...


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## johnrsemt (Apr 18, 2018)

Ladder truck is a good idea


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## E tank (Apr 18, 2018)

johnrsemt said:


> Ladder truck is a good idea




Thanks...I was kidding tho...


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## chriscemt (Apr 29, 2018)

Shelby Stotts said:


> The instructor didn’t specify how they did it. But said they considered using a basket on a heli. Thanks!



I'm reminded of the story of my third grade teacher telling me (the entire class, actually) that airline pilots knew how to put their eyeballs back in their sockets after hard stops, since it happens so often...


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## Cameron S (May 5, 2018)

Get several people underneath the trampoline to support the patient on a spineboard, cut holes for someone to collar and put down the blocks and then cut around the board, transport the patient with a thin layer of trampoline canvas at their back


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