kindofafireguy
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And along that vein is a great saying:
"You can't fix stupid, but you can sure as hell knock it down and tube it."
-anonymous
A fall that the hospital gave me grief about
- Thread starter KyleG
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And along that vein is a great saying:
"You can't fix stupid, but you can sure as hell knock it down and tube it."
-anonymous
DesertMedic66
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firecoins
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Who asked your opinion? Nobody.
Epi-do
I see dead people
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What can I say. There is way more stupid in the world than I have time to deal with. When I precept students, that is often a topic we talk about. We discuss how to pass the test "everyone gets high flow O2" but spend more time talking about how to determine who actually needs O2, how much, and what method of delivery is most appropriate. If they are never taught, they will never learn how to figure it out.
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I wonder how many "providers" realize that spinal injuries do not automatically indicate nervous system damage and are really just another fracture. You could "break" every vertebra in your body and being walking around with no deficits whatsoever, though I bet you'd be in some pain.
A backboard does nothing for these fractures but make it more uncomfortable. It's not preventing them from getting any worse because short of another significant insult, the fractures are not going to get any worst.
Here's my little spinal story:
I hit a tree skiing a few months ago and fractured my L4 and L5, there were no neuro deficits and I managed to convince the ski patrol to not immobilize me. Unfortunately once I laid down in the sled I could not get back up (too painful) and had to be transported to the hospital on a board sans collar and it was horribly uncomfortable and made the pain worse. When I asked the doc if I was a typical presentation he said absolutely and that the very fast majority of spinal fractures are quite stable.
I have no studies, though I have read a few of the ones that Aidey posted as well as the the National Association of Athletic Trainer's position statement on spinal injury care and wholeheartedly agree that we do it far, far too much.
A backboard does nothing for these fractures but make it more uncomfortable. It's not preventing them from getting any worse because short of another significant insult, the fractures are not going to get any worst.
Here's my little spinal story:
I hit a tree skiing a few months ago and fractured my L4 and L5, there were no neuro deficits and I managed to convince the ski patrol to not immobilize me. Unfortunately once I laid down in the sled I could not get back up (too painful) and had to be transported to the hospital on a board sans collar and it was horribly uncomfortable and made the pain worse. When I asked the doc if I was a typical presentation he said absolutely and that the very fast majority of spinal fractures are quite stable.
I have no studies, though I have read a few of the ones that Aidey posted as well as the the National Association of Athletic Trainer's position statement on spinal injury care and wholeheartedly agree that we do it far, far too much.
Actually,
I'd like to think I know a little about trauma and the care of it. I have been to skule a few years.
I seriously doubt the benefit of longboards.
They were an expert opinion based on a theory that has been discovered to have a lot of flaws in it.
The only reasons I can think of to use them at all is
a. because you are obligated to follow a protocol.
b. to help extricate somebody out of a space like a car, trench, etc.
A pillow splint is a legitimate prehospital immobilization device.
What if that "pillow" was a 6 foot long cot matress? (sort of like a giant vacuum splint concept don't you think?)
Aidey
Community Leader Emeritus
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Bloody hell do I miss full body vacuum splints. Those things are amazing for hip patients.
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We have one at my sports medicine job and I would like to see it get used more. However it is very large and would be a bear to get out on the ice. We also struggled to make it work for supine spinals, finding it pretty much a much to use the scoop to get them onto it, do you have a better technique perhaps?
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What about the old military litters that were two wooden poles with canvas between them?
Probably not much difference there either as long as you were not almost bouncing out of it as you were being carried.
mycrofft
Still crazy but elsewhere
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We used the folding canvas stretchers by Ferno Washington that were always stretched laterally but folded in half longitudinally, and a short board (didn't have KED, 1981 midwest) if extrication was from/through a limited space. AND care, plus good coordination moving and positioning the pt., as well as a Philly collar. No ER complaints, and pt was not bouncing around thanks to care and having the ambulance litter (gurney/cot/bed whatever) as close at hand as possible.
I am greatly heartened to be reading here (and hearing in training materials) the reasoning process: splint to move, not treat. I am starting to hear more reasoning going into spine boarding. Hate to lose a potentially important tool just because it is more limited than we were and are taught.
I am greatly heartened to be reading here (and hearing in training materials) the reasoning process: splint to move, not treat. I am starting to hear more reasoning going into spine boarding. Hate to lose a potentially important tool just because it is more limited than we were and are taught.