Collar, or no collar? Gsw to the head.

[gotbeerz001]

Wow that is impressive. I would love to see his scans and records!

ME TOO!!! I ran into him the other week (transported his mom) and had a brief chat with him in the waiting room. While nice to talk to, I can't help but think he caught me checking out the scars.

 

[highglyder]

That's how I've started referring to C-collars when talking through scenarios with our new guys....why didn't we board and collar the 80 something year old patient involved in the TC? Well he was walking around on scene as well as you and me without any traumatic injuries, in fact his chief (and only) complaint was extreme hypertension. "Yeah but, because of his age and mechanism".....so should we have also applied our bilateral Sager splint on his legs, air splints on his arms and taped trauma dressings to his chest to stabilize possible flail chest segments? No, because we found zero signs/symptoms of those injuries, just like we found zero s/s of a neck or back injury, and just like we don't break out the Sager based on mechanism alone, neither do we with collars or boards.

As written in the JEMS article Research Suggests Time for Change in Prehospital Immobilization by Jim Morrissey
"Especially troubling has been the lack of emphasis on the assessment of the patient before making a decision about immobilization. Historically, more emphasis has been placed on what happened to the vehicle or the best guess on how far someone may have fallen, instead of what actually happened to the person."

In other words, medics should be taught to not treat the scene, just as one would not treat the monitor. Yeah, what happened to the other guys is not necessarily as important as we think since he is the other guy. Different people, different factors, different variables, different presentations = different treatment. Use the scene to help you guide your assessment, but not how to treat the patient.