Fall Patient - Your treatment

[wolfwyndd]

Personally, I wouldn't have recomended a C-spine immobilization either, however, if ANYONE else on the rig would have suggested it, sure, I would. I would actually be a bit more concerned with the abnormal abdomen (say that 5 times fast) then his neck pain.

That's a not so nice sunday surprise that he had a c-2 fracture.

 

[FF/EMT Sam]

C-Collar, LBB, O2, Call for ALS, Fast Transport

 

[trauma1534]

Come on people, let's get real. Why LSB or C-coller? No MOI, if it were that severe, he would not have been able to get up. 2 feet fall? Are we not taught to only LSB if pt falls 4x's thier hight?

I would transport him in a position of comfort. He is A&Ox4... wonderful! Airway is not compromized. What is the big deal? What about his hand grips? Does he have good PMS present x 4? Are there any deformities? I wouldn't sweat it. He would just get a routine transport to the local ER. While this is something that needs to be treated, it is not life or limb threatening.

Sometimes people are being immobilized when they shouldn't be. Rememeber the saying "first do no harm". Why try to streighten the neck and put him in a c-coller? Are we not tought to splint them as we find them, unless there is no palpable pulse present? THis does not even warent splenting.

 

[yowzer]

Based on the description of the patient, I wouldn't have gone with a collar and backboard either. It doesn't sound like he meets the criteria. Well.. maybe if he had a history of brittle bones or osteoporosis. As long as you follow your protocols, and document everything, you're on pretty safe ground.

Wouldn't be too concerned about the hernia either; if it's that big, it's been there a while. Liver problems?


If he doesn't know what medications he's on, go through his bathroom and kitchen looking for pill bottles.

 

[Ridryder911]

C-Collar, LBB, O2, Call for ALS, Fast Transport

Okay ... justify the above treatment?. Collar..hmmm... maybe, okay.. LSB.. 02 for what reason? ALS again for what reason? .. and fast transport? So you are going to endanger someone with a spinal problem?.. Hmm last I read, and heard spinal precautions are supposed to be nice, smooth transport.... I don't see any urgency here...

[QUOTE="trauma1534] Are we not taught to only LSB if pt falls 4x's thier hight?[/Quote]
Never heard, read or seen that one.. so if they are 6' tall they have to fall 24 feet before you LSB someone.... I don't think so!
Any MOI that suspected cervical, spinal precaution should be considered for spinal immobilization, especially those with osteoporosis and the elderly. However, this scenario does not meet those criteria (ground level fall and non-sos of cervical pain.

R/r 911

 

[jeepmedic]

Any Fall that Pt. complains of neck or back injury gets c-spine and LSB. I don't care about any ground level fall or fall 4x there height. I have seen more than one pt c/o neck and back pain that fell from a sitting or lying position that resulted in some type of neck injury. It may be a 1 in a million pt. but it only takes that one to make you a former EMT!!!! Use a back board.

 

[trauma1534]

Let me correct myself on something. When I posted earlier about not backboarding 4X's someone's hight, I was wrong. I don't know what I was thinking. That is our criterior for flying a fall patient out. However, I still would not have backboarded this patient. In my opinion it would have caused more harm than good. I am not sure how I would have c-collered him. With his neck stiff and to one side, there again, seems like I would have caused more harm than good. I can see how that would have been a tough call for someone to make the right decision though. In our area, there is a big thing of clearing c-spine in the field. I don't agree with it. But our recieving facility is not as strong on patients being backboarded for that reason. Follow your gut in the field, and when in doubt, call med controle.