Here is the situation. We are transporting a pt that just had a cervical fusion surgury 5 days ago to do a MRI scan. Pt c/o severe pain around the shoulder and neck. Nurse gave him some pain med right before we transport. So after administrated the med. We move the pt to our gurney via 4 people drawsheet. The RN was holding the head and I told her to count. She start transfering the pt right after she counted one. Pt c/o he is in more pain now. So I told my partner we should backboard him to prevent this kind of situation happening and will be so much easier to move the pt without moving his neck. We have to move the pt few more time from our gurney to bed and back and fore. I am just worry that if we keep doing this, it will further aggrivate pt's pain and may cause spinal damage (pt was sent to MRI due to lost of snesory on both leg after the surgery). Then my partner looks at me and laugh saying I just want to be a hero. Am I overkill or over concern about the pt's neck pain? What would you do if the pt keep c/o neck pain everytime you move him?
Am I overkill?
- Thread starter LeoLi4
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I don't think the backboard is going to help.
There should be a slie board at the MRI and initiating facility to make the movement less disruptive to the patient and care will have to be taken, not the normal meat slinging.
I also think if the pt is in so much distress anesthesiology needs to be involved with far more tools in the box than nursing.
There should be a slie board at the MRI and initiating facility to make the movement less disruptive to the patient and care will have to be taken, not the normal meat slinging.
I also think if the pt is in so much distress anesthesiology needs to be involved with far more tools in the box than nursing.
JPINFV
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I'll second the use of a slide board. One thing to remember with the MRI is that most backboards includes metal buckles.
Aidey
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I would go for a slide board and if that isn't available, maybe a break-a-way board or scoop stretcher. A back board would have been excessive, uncomfortable, and likely there would have been more spinal movement rolling the guy onto it than just sliding him on the sheet.
When moving pts with injuries in the future make sure that everyone is on the same page. For example "Ok, RN Joe, you're on the head so we will move on your count, is everyone ok with a count of 3?". I try an make sure that either myself or my partner are on the injury when moving the pt, and I always always ask "is everyone ready" and wait for everyone to respond before I count.
I agree with whoever it was that said it may not have been enough time for the meds the RN gave to kick in. Even the fast onset IV meds can take a couple of minutes.
Honestly he has an injury, it's going to hurt when he is moved. It sucks, and we try and do what we can to minimize the pain, but the fact is when you move an injured person it is nearly impossible to not cause them some increase in pain. That is why you take your time, communicate clearly and re-assess neruo after every move. Even in pts with an obvious injury taking your time and going slow may be the best thing for them, rather than just scooping and running. I've sat on scene for 20-30 minutes with pts getting an IV, giving pain meds, waiting for them to kick in and then applying the splint or moving them.
When moving pts with injuries in the future make sure that everyone is on the same page. For example "Ok, RN Joe, you're on the head so we will move on your count, is everyone ok with a count of 3?". I try an make sure that either myself or my partner are on the injury when moving the pt, and I always always ask "is everyone ready" and wait for everyone to respond before I count.
I agree with whoever it was that said it may not have been enough time for the meds the RN gave to kick in. Even the fast onset IV meds can take a couple of minutes.
Honestly he has an injury, it's going to hurt when he is moved. It sucks, and we try and do what we can to minimize the pain, but the fact is when you move an injured person it is nearly impossible to not cause them some increase in pain. That is why you take your time, communicate clearly and re-assess neruo after every move. Even in pts with an obvious injury taking your time and going slow may be the best thing for them, rather than just scooping and running. I've sat on scene for 20-30 minutes with pts getting an IV, giving pain meds, waiting for them to kick in and then applying the splint or moving them.
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Melclin
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It sounds like all that was needed was better transferring technique and more communication.
Good on you for giving enough of a toss about it to put some thought into it though.
Good on you for giving enough of a toss about it to put some thought into it though.
Aidey
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It's the US, many people aren't aware they suck and there are better options not being used.
One of these days I'm going to find that Maylasian study, print off about 200 copies, and hand it out every time someone says we should back board a patient when it's not indicated.
busmonkey
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I would second the use of a slide board or a break away board, they are easier to use, less disruptive and, especially with a slide board - there is often no metal therefor the need may be less to take him off of the board once at the MRI depending on the operators orders. I also agree that if the patient is c/o of pain that severe, I think that anesthetics should be used.
Know the best option? Talk to the doctor, tell him/her your concerns with possible movement, possible injuries they might receive, etc.
i cant count how many times i've just gone up to the doc, told them "hey, you know they will be bouncing around in an ambulance for the next half hour right?" and they say "oh crap, you should board them then"
even if they say no, its a higher level of cares decision, or contact a supervisor.
they are there for a reason, to provide insight in these "grey" areas.
or do like everyone else does, CYA, and board them if you're concerened, its your patient, but also remember, they have the right to know what is going to happen to them, if you tell them the process and they dont agree with it, they can refuse you putting them on a board.
ahhh grey... i love grey.
i cant count how many times i've just gone up to the doc, told them "hey, you know they will be bouncing around in an ambulance for the next half hour right?" and they say "oh crap, you should board them then"
even if they say no, its a higher level of cares decision, or contact a supervisor.
they are there for a reason, to provide insight in these "grey" areas.
or do like everyone else does, CYA, and board them if you're concerened, its your patient, but also remember, they have the right to know what is going to happen to them, if you tell them the process and they dont agree with it, they can refuse you putting them on a board.
ahhh grey... i love grey.
livewiremaxx
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I agree with most here ... Backboard wouldnt do much. Think about how uncomfortable taht would be for the pt. in the long run. Good transfer would work best. Keep him comfortable.