LSB or Scoop Strecher??

[MedicPrincess]

she needed a hair traction if anything

I guess I am still confused by this. I read the article. Even though it is technically the "femur" that is fx, the entire article still refers to it as a hip fx. But it did say some traction would be ok

To help with the discomfort of a displaced fracture, 5 lb of longitudinal (Buck’s) skin traction can be used, although pillow support alone has been shown to be just as effective

.

So my question to you is, in your system, does your protocols have you you pulling traction on a hip fx w/ rotation and shortening, just in case its the femur involved? And do you do it with all patients who have r/s?

Our system is sheet splinting and pillow support, "consider" pain meds. Often the sheet splint and pillows make it tolerable.

 

[Ridryder911]

Interesting article and maybe you should read it sometime. I do not see anywhere on placement of a longitudinal traction device for surgical neck fractures or commonly called 'garden fractures". If you want to get technical, please refer to the manufactures guidelines of use for "mid-shaft femur fractures" for the use of traction. Furthermore, placing pressure on the ischium, will cause induce and needless pain, since that is near the site of the fracture. This is not to be confused with traction devices such as "bucks" etc...

Furthermore, phenergran is usually withheld from patients > 70 not so much of "breakdown" in the liver (which all meds should be considered, in that age group) as much as it causes delirium and temporary psychoses. Other, anti-emetics, should be considered.

Yes, pain is real and should be treated as much as the fracture would be. I suggest reading AMA's and FACEP, NEMSP viewpoints and suggestions of such. If one is worried about respiratory depression with use of opioid analgesics, then one should not be given authority to administer medications. Especially paramedic level, knowing narcan can reverse, as well as one should have the knowledge and capability of managing the airway.

In recent years, not addressing and managing pain properly is one of the popular areas of litigation and loss of health care providers, this includes physicians, nurses and yes even EMS personnel.

Personally, both are good immobilizers.. however; the scoop can be removed more easily. If this is an isolated injury, one should not have to remain on a LSB for a long period of time, as research has shown, LSB can produce as many injuries as they prevent.

R/r 911

 

[micsaver]

...she needed a hair traction if anything, you need to look at the age of pt's sometime, old people are like glass, the more crap you pile on them the eaiser they break

Um I do believe that traction splits are contraindicated for Hip injury, knee injury or tib/fib injury. As far a I know Traction Splits are made purely for Femur fx.

 

[KEVD18]

8.22.2006 yep, thats when the last post on this one was, over two years ago.....

 

[mikie]

KEVD to the rescue!

 

[knxemt1983]

One of our units had this "disagreement" with ALS Fire. Keep in mind, per our protocols, we can clear C-Spine in the field. ALS Fire has the same Medical Director and same protocols as we do.

LOLFDGB in her bathroom. Its a very small hallway bathroom. Definantly one of those 1-butt bathrooms. Its a toilet and a sink. 94 y/o Pt c/o of excruciating pain in the hip region. Doesn't really isolate, just kind of says "here" and waves her hand over. Patient has rotation/shortening. At this time the patient denies neck or back pain. Denies LOC. Family onscene confirms no LOC.

Fire onscene for approximately 6 minutes prior to EMS arrival. FD Medic has been a Medic since I was in diapers, has been instructing EMT and Paramedic programs for 10 years, was a medic with our service until he crossed over to the darkside and got his firestandards too, the entire alphabet after his name, bedside manor with patients tends to be way above and beyone, but is a but rough around the edges with his EMTs. (he has this silly notion that if you passed your state exam you should be able to perform the BLS skills of an EMT)

So, they have the patient sheet splinted, vitals being monitored, assessment done. They have not spinal immobilized her. The FD Medic has cleared her C-Spine.

As the ambulance is pulling up, dispatch advised them the FD needs them to bring in their scoop stretcher. Medic for EMS says hold on before getting the scoop stretcher and let him go in and assess. This is the same Medic that I worked with before that scared me so bad with his driving. Theres a thread somewhere....

They get inside, FD's Medic says Crap, he'd advised Fires dispatch to advise the EMS unit to bring their scoop stretcher. The EMS Medic says, yea we got that, but I'm not going to use it and sends his EMT for a LSB.

And suddenly there wasn't enough room for anybody in that room because the Egos began to swell and feelings were hurt and FD called their Chief and EMS called our Shift Commander and suddenly there weren't 2 professional Paramedics with that patient, there was a brand new FF/EMT who is still trying to feel out his Medic partner, the EMS EMT who had the LSB and a couple of preschoolers fighting over who was right. Pathetic, I know.

So....which would you guys have used, LSB or Scoop, and why?

sounds to me like some people need to learn what the work TEAMWORK means. I always try and work with fire, ultimately my rear is the one that gets chewed at the ER, but really in this scenario I would prefer the scoop also unless I missed something in the post. Then again it's just personal preference, reason being if she doesn't need full immobil, then I can remove the scoop once in the rig for patient comfort. hip immobilizers are nice to because you can lay them out on the cot, then move pt on with scoop and remove scoop then apply it.

just my 2 cents

 

[KEVD18]

8.22.2006 yep, thats when the last post on this one was, over two years ago.....

seem appropriate to bring this up again!!!!

 

[Jon]

OK... Post is over 2 years old... and EMTPrincess is now MedicPrincess.
Protocols might have changed, etc.