Immobilize or not?

[epipusher]

I love how in real life, and especially in this forum and among others, anyone who plays it safe is a "cookbook" medic. And playing it safe is therefore a detriment to our profession. Pushing 16 years in EMS with over half as a medic, I will play it safe every time. Feel free to blame me, along with the majority of my "cookbook" co-workers, as bringing down the profession as a whole.


edit: my fellow motor bicycle riders can blame me as well for killing our cool look due to the fact I wear a helmet.

 

[mycrofft]

A generalization, but some folks do throw the "cookbook" thing around pretty casually.

You have to follow your educated sense of the situation at hand as long as it is within prudent practice. Hopefully it meets protocols, and 90+% percent of the time the protocol is right, as long as your eval and conclusions are right. If you break protocol due to a faulty conclusion, then good luck to the pt and to you. If you are cautious and tend to be conservative without harming the pt, it minimizes the chances you will go afoul or get in trouble.

That said, having helped write them, the prospect of someone slavishly following a protocol to a bad end (due to undetected complications or an errant conclusion or eval) was one of my nightmares.

My assumption is that, in this case, and with the eval we were given, the pt was not in need of spine boarding simply on the complaint of a sore neck. If it had involved a motor vehicle accident or alteration, I'd entertain a higher index of suspicion and might have taken the calculated risk to spine board the pt. However, if it met local protocols, then board if you will, whether it makes overall sense or not. Might catch something nobody had detected.

(Someone told me I'm wishy-washy about these nothings. I am ambivalent; but only when I don't have the pt in front of me. Forty years seeing victims and patients tells me that armchair DX'ing is always hit or miss).