C-spine/packaging and CPR and ROSC

[NomadicMedic]

How do their ROSC and neuro outcome rates compare to stay and play?

About how you'd expect. A "save" here is delivering a corpse with Epi induced pulses to the ED.

When I set up shop to work an arrest on scene everybody, and I mean EVERYBODY, freaks out. The fire department doesn't know what to do, my EMT keeps making "let's go" gestures, the cops are saying thins like, "shouldn't you be going to the hospital?"

Just one more reason that I'm looking for a better job.

 

[EpiEMS]

When I set up shop to work an arrest on scene everybody, and I mean EVERYBODY, freaks out. The fire department doesn't know what to do, my EMT keeps making "let's go" gestures, the cops are saying thins like, "shouldn't you be going to the hospital?"

Craziness, truly. Public education would go a long way on this! (My kingdom for a service that does any meaningful public education!)

 

[DrParasite]

Craziness, truly. Public education would go a long way on this! (My kingdom for a service that does any meaningful public education!)

screw public education, it seems like provider education is a more pressing issue (and by provider, I mean the ambulance EMTs, firefighters and cops)

 

[EpiEMS]

screw public education, it seems like provider education is a more pressing issue (and by provider, I mean the ambulance EMTs, firefighters and cops)

You're spot on with this. Getting rid of the "board 'em all" mentality is going to be hard unless we can get all of our colleagues to buy in to it. (Not that there's anything to "buy in" to - other than all the evidence).

 

[NomadicMedic]

Sure. But that's a cultural thing. Unfortunately, the culture at my present service doesn't stress education or evidence-based medicine.

OK, let me back that up a bit. There are some that stress evidence-based medicine and education, but on the whole the service is a bunch of "been there done that" medics who feel that pain management can wait till you get to the hospital and that everybody goes on a backboard. It's frustrating, but until I move somewhere else, it's my reality.

 

[DesertMedic66]

We are very hit and miss with evidence based medicine. Our protocols allow us to really not backboard anyone (however we have some medics and fire departments who still backboard everyone). On the opposite side we still only have pain medication as a standing order for extremity trauma with a handful of local doctors who will give orders for ABD pain.

 

[Kevinf]

Our protocols specifically discourage a backboard during transport, but good luck getting the old guard to follow that.

In a constant effort to provide protocols that are based upon strong clinical evidence, these changes address an increased recognition that there is not strong evidence for the effectiveness of backboards, but there is evidence that they are harmful in some situations. For that reason, there is more emphasis on using clinical criteria to determine which patients require restriction of spinal motion. The backboard now has a reduced role during transport of patients, but it may still be useful in some situations to assist with extrication.

Spinal Care
Apply rigid cervical collar. If nonambulatory, use backboard, scoop/orthopedic stretcher, vacuum mattress, or other device to move patient to stretcher with minimal spinal motion. CID may be used to further restrict spinal motion. Transport on stretcher mattress without backboard if patient ambulatory or if scoop/orthopedic stretcher can be removed with minimal patient motion.

 

[VFlutter]

If you plan on flying a patient out it may be worth placing them on a backboard just for ease of loading/unloading

 

[VentMonkey]

If you plan on flying a patient out it may be worth placing them on a backboard just for ease of loading/unloading

I do prefer it over the "patient mover" portion of our LifeBlanket, though once it's placed it's very convenient; Mega Movers work well, too.

 

[TXmed]

If you plan on flying a patient out it may be worth placing them on a backboard just for ease of loading/unloading

Alot of my co-workers feel this way, but i respectfully disagree. I have no problem and have had little delay on just using a sheet to move the patient to our loading system. I am also a stickler about sitting our patients up at least 30 degrees both intubated and non-intubated. Ive found the ease of movement is more based on if everyone is on the same page.

 

[Bullets]

About how you'd expect. A "save" here is delivering a corpse with Epi induced pulses to the ED.

When I set up shop to work an arrest on scene everybody, and I mean EVERYBODY, freaks out. The fire department doesn't know what to do, my EMT keeps making "let's go" gestures, the cops are saying thins like, "shouldn't you be going to the hospital?"

Just one more reason that I'm looking for a better job.

I love being this guy....Our town has a paid engine that "helps" on CPR calls and they do the same thing, even though our director has had about 124542244 converstions with them about why we dont load and go with CPRs.

i may come work in Delaware jusrt so i can crush everyones dreams

 

[NomadicMedic]

I love being this guy....Our town has a paid engine that "helps" on CPR calls and they do the same thing, even though our director has had about 124542244 converstions with them about why we dont load and go with CPRs.

i may come work in Delaware jusrt so i can crush everyones dreams

Oh no, DE is a stay and play state. (I haven't changed my user name.) I'm actually in georgia.