Log Roll Pelvic Injury

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Bulldog Medic Student

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Arrived on scene to find a 30ish female. She had a fall from a veichle in another town. Family attempted to drive her home. Got as far as our district. Partner and I find her lying on the grass on the side of the road screaming in pain. Chief cmplaint a 20 on 1-10 pain scale for right hip area. Cant touch it , no visible signs of fracture, dislocation, bruising, bleeding or swelling.
We acess her, manual c-spine, collar and backboard her.
Now for the question half of ems on scene wants to roll her to her good hip, the other half says the bad hip. Which way would you go? I'll tell you what we did and why. But need to know what you think.We did eventually palpate it and felt no movement.
 
Um, don't log roll her?

1. How did she get out of the car?
2. Why did you put a c-collar on her?
3. Is the back board being used as a splint of her hip or because you think she needs to be back boarded?

If you insist on putting her on the back board there is a scoop stretcher or sliding the board under her via any number of methods. Alternatively you could let her lie there until the pain medications take effect and then move her.
 
Used a c-collar because we had no idea of what had happened to her. Her injury happened 3 towns away. No idea of how she got out of the veichle she was laying on the ground. Yes we probably should have used the scoop but we didnt. Except for driver they were all exhibiting signs of intoxication strong alcohol odor on pt and others.
 
No scoop on board...now what??

Do tell, gang
 
Bulldog Medic Student said:
Where did I say we didnt have scoop on board?
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He's changing up the scenario to see how they would change treatment.

As for me, if I didn't have a scoop, I'd wait for opioids to kick in, then see if we can get a people mover under her and transfer her to a board that way if we absolutely wanted to torture her with useless spinal immobilization.
 
firetender said:
Do tell, gang
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Lots of people? Just lift her straight up... about 3" and slide the backboard under her, lower to board.

Not a lot of people? Log roll to good side. Much mass on injured area may cause additional injury. It's going to hurt anyway.
 
Let's just say...

No scoop. Now what?
 
Damn, I thought YOU re-stocked the drug box?

jtpaintball70 said:
if I didn't have a scoop, I'd wait for opioids to kick in, .
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No opiods on board, but don't let me forget your idea! In fact, just you and your partner and a backboard with all your whatever spinal immobilization gear, just no scoop..

Maybe, what first?
 
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firetender said:
No opiods on board, but don't let me forget your idea!
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Even without opioids, getting a people mover under her, while it might take longer, probably would hurt less than a log roll to either side. I won't let ya forget it :)

EDIT: No fair editing your post!

Hmm... Lets see, standard immob equip... straps, board, blocks, collar... towels... I'm drawing a blank. But then again, I hate immobilizing patients
 
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jtpaintball70 said:
Even without opioids, getting a people mover under her, while it might take longer, probably would hurt less than a log roll to either side. I won't let ya forget it :)
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If you can easily slide or lift inline... it'll do nicely and not hurt as much as a log roll.
 
Bulldog Medic Student said:
Used a c-collar because we had no idea of what had happened to her. Her injury happened 3 towns away. No idea of how she got out of the veichle she was laying on the ground. Yes we probably should have used the scoop but we didnt. Except for driver they were all exhibiting signs of intoxication strong alcohol odor on pt and others.
Click to expand...

What do you think the chances of her having a c-spine injury were if she managed to get back into a car, and then out of it and onto the ground? No offense, but if you had a scoop and didn't use it that unjustifiable.
 
Bulldog Medic Student said:
Used a c-collar because we had no idea of what had happened to her. Her injury happened 3 towns away. No idea of how she got out of the veichle she was laying on the ground. Yes we probably should have used the scoop but we didnt. Except for driver they were all exhibiting signs of intoxication strong alcohol odor on pt and others.
Click to expand...

You said you didn't use it.
 
No drugs, but do we have an extra LSB?
 
I'm pretty much with Akula - lift her if you've got the hands. If she's made it this far and doesn't have any tenderness/deformity along the spine, and all that good stuff, checks out on neuros in extremities and such... move her the least painful way possible. If she's not complaining of any midline tenderness/pain etc etc... aside from the whole thought process that says MVA = automatic spinal immobilization, the only benefit to an LSB in my opinion is to make it somewhat easier to splint her pelvis. Of course this is under the assumption we don't have a scoop... which we should.
 
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