About That

[Future EMT 07]

This past Saturday I did a ride-along with my local fire department. We got called to a rollover MVA and the kid was messed up pretty mad. They back boarded him and everything but they didn't do anything to his 2 passengers who said they were fine. I was just wondering shouldn't the other passengers have been back boarded as a precaution.:unsure:

 

[ffemt8978]

Did the other two passengers want treatment and not get it, or did they refuse any treatment? Makes a big difference.

 

[Future EMT 07]

Did the other two passengers want treatment and not get it, or did they refuse any treatment? Makes a big difference.

well they said they were fine but i thought you couldn't refuse treatment without parental consent. I probably should have mentioned they were all 16 and none had parents there.

 

[ffemt8978]

Well, my protocols still wouldn't have allowed us to take c-spine precautions based upon mechanism alone. As a matter of fact, we are specifically prevented from using MOI to determine if spinal precautions are necessary.

 

[islandgal]

Can you explain that further? I don't understand the reasoning as far as not taking c-spine based on MOI as a precaution.

 

[rescuecpt]

Theoretically, the two kids who said they were fine were "unfounded" patients. Someone probably called the ambulance because they saw a rollover, or those two kids, who were fine, called for their friend. If their friend wasn't hurt, they may not have called for an ambulance at all, probably just the cops and a tow truck.

 

[ffemt8978]

Can you explain that further? I don't understand the reasoning as far as not taking c-spine based on MOI as a precaution.

Yep, here is what our protocols state:

Our protocols state that we are not to board and collar a patient if communication is possible and all of the following conditions are met:

1. Patient is CAOx3
2. Patient not under influence of drugs or alcohol
3. Patient has no complaints of neck pain
4. Patient has no complaints of arm or leg numbness
5. External exam reveals non-tenderness
6. NO distracting injury

 

[islandgal]

Thanks for passing that on

 

[FF894]

This past Saturday I did a ride-along with my local fire department. We got called to a rollover MVA and the kid was messed up pretty mad. They back boarded him and everything but they didn't do anything to his 2 passengers who said they were fine. I was just wondering shouldn't the other passengers have been back boarded as a precaution.:unsure:

MOI and age are both conditions of getting boarded and coming for a ride to get checked out.

 

[fm_emt]

Yep, here is what our protocols state:

Our protocols state that we are not to board and collar a patient if communication is possible and all of the following conditions are met:

1. Patient is CAOx3
2. Patient not under influence of drugs or alcohol
3. Patient has no complaints of neck pain
4. Patient has no complaints of arm or leg numbness
5. External exam reveals non-tenderness
6. NO distracting injury

Around here, they get c-spined & boarded most of the time anyway. Like my unconscious pt at the punk band concert.. he had - neck pain, - arm or leg numbness, - pain anywhere, really. But when FD showed up, they c-spined him. Still probably more of a CYA, though.
If they're under 18, they get collared regardless. Yes, we probably overtriage minors, but again, it's a CYA.

 

[Tincanfireman]

I'm not disagreeing with anyone's protocols, but I'd rather backboard 100 patients for CYA reasons than see a subpoena with my name on it...:unsure:

 

[EMTalex]

Where i'm at we c-spine with any sign of possible trauma....well with regards to moi

 

[Guardian]

This past Saturday I did a ride-along with my local fire department. We got called to a rollover MVA and the kid was messed up pretty mad. They back boarded him and everything but they didn't do anything to his 2 passengers who said they were fine. I was just wondering shouldn't the other passengers have been back boarded as a precaution.:unsure:

That can be a tough decision even for an experienced paramedic. Every situation is different and after a while you will develop a feel for it. My advise for people just starting out is to over treat your pts. No this doesn't mean shoving a NPA down their nose. But if there is any question, take a few extra minutes to backboard them because when your dealing with 16 y/o children, they can't be trusted to make the right decision by themselves. It's your responsibility to take care of them.