15 year old female hit in head with softball

[Hunter]

No idea what is actually in the first responder curriculum now-a-days but it is grossly over simplified to say anyone with a head injury has a potential spine injury.

Your instructor may have been taught that, he may actually believe it, it may be in your loca protocols, but it is just an outright stupid idea. In fact it sounds stupid just to think about ir.

Erm a giant rock flying at your head at 50mph won't cause spinal injury? It can easily force your head to swing back or depending on the angle might even possibly compress the cervicle spine. I'm not sure what about physics sounds stupid to you... just saying...

However as far as the OP goes, I'd have considered a c-collar, depending on my assessment of patient would determine wether I go through with it or not. Rather play it safe than possibly cause more harm by withholding a treatment based on how other patients reacted in similar situations.

 

[Sasha]

Erm a giant rock flying at your head at 50mph won't cause spinal injury? It can easily force your head to swing back or depending on the angle might even possibly compress the cervicle spine. I'm not sure what about physics sounds stupid to you... just saying...

However as far as the OP goes, I'd have considered a c-collar, depending on my assessment of patient would determine wether I go through with it or not. Rather play it safe than possibly cause more harm by withholding a treatment based on how other patients reacted in similar situations.

It doesn't hurt that bad. It's a softball. It's SOFT.

Just kidding. Couldn't resist though.

If there is no neck or back pain I don't really suspect injury. I'm probably a little lax though.

 

[Aidey]

Erm a giant rock flying at your head at 50mph won't cause spinal injury? It can easily force your head to swing back or depending on the angle might even possibly compress the cervicle spine. I'm not sure what about physics sounds stupid to you... just saying...

However as far as the OP goes, I'd have considered a c-collar, depending on my assessment of patient would determine wether I go through with it or not. Rather play it safe than possibly cause more harm by withholding a treatment based on how other patients reacted in similar situations.

The neck is intended to bend, and can absorb a lot of energy. Since when does bending equal a spinal injury? If spinal injuries easily occurred from bending we would hear a lot more about people being paralyzed at tennis and volleyball matches. Also, how would it compress the c-spine? Compression injuries tend to occur from axial loading, like a diving injury.

In addition, please do some research on the use of c-collars and backboards. There are multiple proven negative side effects. It is very likely that you will cause more harm by using a c-collar and a backboard in this case than you would by not using them.

 

[JPINFV]

If you're not transporting, make sure to throw a little education on subdural bleeds and the lucid period.

 

[mycrofft]

Ask if the neck hurts. Palpate. Check consciousness. Follow local protocols, but probably no spinal injury unless it happened secondary to the fall (freak fall).
Rinse and repeat.

 

[musicislife]

Would this be a 911 call? (if youre a bystander watching it)

 

[musicislife]

General rule for C Spine imobilization?

what are some general guidelines for when to collar or not to collar?

 

[Maine iac]

If it looks like a situation where medical intervention is needed (kid still down, parents around kid) calmly walk over and ask if you can call 911.

After that introduce yourself, and say you know first aid and would they like your help.

Only then should you,

Do a thorough assessment, and decide on your treatments based upon that assessment.

Is a ball to the head MOI for spinal precautions? Maybe in your opinion, but it comes down to the attending emt/medic who will be taking over.

 

[musicislife]

would you hold c spine until the medic arrived?

 

[Akulahawk]

In general, I would not be inclined to place the catcher in c-spine precautions of any sort, especially if I didn't find any signs of cervical injury during the exam. I would, however, evaluate for concussion... but I don't see anything normally more serious than perhaps a Grade 1 concussion occurring with such a hit from a thrown softball. The catcher's helmet is normally pretty darned good at absorbing impacts from said thrown object...

 

[Tigger]

The neck is intended to bend, and can absorb a lot of energy. Since when does bending equal a spinal injury? If spinal injuries easily occurred from bending we would hear a lot more about people being paralyzed at tennis and volleyball matches. Also, how would it compress the c-spine? Compression injuries tend to occur from axial loading, like a diving injury.

In addition, please do some research on the use of c-collars and backboards. There are multiple proven negative side effects. It is very likely that you will cause more harm by using a c-collar and a backboard in this case than you would by not using them.

Exactly, a blow just to the head is not likely to be able to move the neck in such a way to compromise the cervical spine unless it comes from directly above. Unless the girl was looking straight at the ground with shoulders rotated backwards, this would not likely happen.

If you're not transporting, make sure to throw a little education on subdural bleeds and the lucid period.

A little talk about concussions wouldn't be bad either, unfortunately I don't think many in EMS feel comfortable talking about them.

 

[ffemt8978]

Multiple threads merged.

 

[the_negro_puppy]

Any loss of consciousness?
Is the patient now GCS15?
Any neck/c-spien pain?
Any altered sensation?

I would consider a C-collar but assess fully. We don't even carry backboard here. At all.

 

[WuLabsWuTecH]

Exactly, a blow just to the head is not likely to be able to move the neck in such a way to compromise the cervical spine unless it comes from directly above. Unless the girl was looking straight at the ground with shoulders rotated backwards, this would not likely happen.

Maybe that's why she missed catching the ball! She is a catcher after all--we pay her to catch the ball...

In any case, I doubt c-spine would be necessary. Doesn't mean I won't think about it--always "consider the need for c-spine precautions" but I would consider it an move on.

 

[Handsome Robb]

OP look up the NEXUS criteria. Rather than trying to pick and choose at random.

I'm not going to lie, my partner and I would have a brilliant laugh about the wacker that called 911 because someone who was wearing a helmet was hit in the head with a ball and someone called 911.

Professional players get hit in the side of the head by 100 MPH fastballs get up and go to first base...

Could this kid be hurt, absolutely. Are they probably just scared and being a little kid, probably. Let parents or coaches make the decision, they are in charge, not you as a random bystander with first aid training. Like someone said offer up your help to the appropriate person, assess the situation and what's going on before you call 911. I hate to say it but I hate running code to calls only to be cancelled on scene or write an RMA. People don't realize how dangerous it is for the crew to run lights and sirens. It's part of the job and I accept that but we need more public education on topics like this, all the 911 education is focused on "Red lights, move right" campaigns and what not which is great but we need education about when 911 is appropriate.

Just to add: it's not only dangerous for the crew, it's dangerous for the public as well along with the fire crew and PD since most places pediatric priority calls, especially trauma calls, will get EMS, FD and PD responding.

 

[mycrofft]

General rules for spinal precautions? The rule is follow your protocols.

Rule of thumb for kids: if you miss something and it goes to court you will lose (same for babies, pregnancies, eyes, hands and genitalia). Follow protocols.

 

[Milla3P]

If it looks like a situation where medical intervention is needed (kid still down, parents around kid) calmly walk over and ask if you can call 911.

This.

If the people in my town followed this one suggestion I would be dispatched for FAR LESS "possible cardiac arrests" for people sunbathing in their yards.

 

[RustyShackleford]

To many patients are boarded to begin with, lets not start boarding every kid who takes a baseball in the melon. Any of us growing up before the popularization of video games and sitting in front of a TV all day fell off our bikes, out of tree houses, off of docks, bridges etc without someone rushing to our side with a spinal board and c collar. Unless a significant weight IE their bodyweight, a meteorite or a cinder block has fallen directly on top of their head to disperse enough kinetic energy downwards to compress their spinal vertebra I would be weary of boarding most head injuries patients, obvious exceptions due to presentation, GCS, mentation, co-morbidities/disease progession. OP look up the Canadian C Spine rule, it rarely fails.

 

[the_negro_puppy]

This.

If the people in my town followed this one suggestion I would be dispatched for FAR LESS "possible cardiac arrests" for people sunbathing in their yards.

Or people driving past minor MVAs calling 911/000 without stopping

 

[Melclin]

NEXUS is for people for whom spinal injury may be suspected.

This doesn't even fall into that category. This is common sense.

Honestly, OP, as a child, how many times were you yourself or did you see others, get hit in the head with balls and objects of all different shapes and sizes? How many times did they say I'm fine, take two paces and *snap* Oh there goes my spine. NEVER.

Use a little common sense, mate.