new WMS research : c spine protocols

[Christopher]

I was KED'ed and it held MY head pretty darn immobile. And that was without a C-collar. It was a brand-name KED and the user knew what he was doing, too.

For the KED to have some means of stopping longitudinal movement, it needs something like shoulder straps (this is why quick clips have never sat well with me, unless you cross them over).

The CED, a much nicer KED, actually has shoulder straps.

All I'm asking is that if you're going to play the "near zero movement" game of spinal immobilization, Do It Right! All transverse and longitudinal movement needs to be stopped. No excuse to leave one or the other unsecured.

 

[mycrofft]

"If you are basing your claims on anecdotal experience, then any treatment will seem to work for anything and everything."
—Steven Novella, MD

Next.

And if I ignore my professional personal experience (qualified observer) at the hands of competent and thorough practitioners ( I am aware of their creds), then I ignore and withhold what data I have to offer...versus the interminable discussions we get into here once in a while about which order to apply and tighten the straps and if color coding is good or not.

I've seen botched KED applications in true extrications. I've seen excellent applications when it wasn't in my opinion necessary. I'm just saying that I was KED'ed by someone who knew what they were doing and I darn well wasn't turning my head without fighting.

EDIT:
Here's a picture of a KED application:

It does not match my experience, in that I had "KED upside my head", whereas this guy barely has KED to his ears. Is this a new version or something? Maybe they applied mine higher up on me for some reason (I'm five-ten).

 

[Anomalous]

I need help settling an argument. How many straps are REQUIRED on a long spineboard? Citing your source would be great!

 

[Medic Tim]

I need help settling an argument. How many straps are REQUIRED on a long spineboard? Citing your source would be great!

That would depend.

this smells of homework.

 

[Anomalous]

Nope. We use 8 or 9 straps now but some want to switch to spider straps and just trying to document our decision.

 

[NomadicMedic]

Nope. We use 8 or 9 straps now but some want to switch to spider straps and just trying to document our decision.

8 or 9? Holy smoke. We use, at most, 5. (If we backboard at all... Which I seldom do)

 

[Anomalous]

If I remember right, it all started with some study from Canada. I think the name of the article was "Fit to be Tied" but I don't remember where or when it was published.

 

[unleashedfury]

Nope. We use 8 or 9 straps now but some want to switch to spider straps and just trying to document our decision.

Spider straps are nice, secure your patient well. but they never seem too fold nicely back in position for storage.

8 or 9? Holy smoke. We use, at most, 5. (If we backboard at all... Which I seldom do)

I'm a huge advocate of selective C-Spine protocols. I've seem EMTs and Paramedics roll up to an accident and just have a patient who was up and walking around go and lie down on the Long back board.

Protocol needs to catch up. this C-spine Long Board Immobilize all traumas, Grandma tripped over her carpet and bummed her knee. By protocol she needs to be C-spined and boarded,

I took some heat the other day from the ER nurses cause I made the choice not to C-spine a fall victim. The guy fell trying to get out of bed, twisted his ankle. Which proved to be broken later, No LOC hell he just fell on his bum after he fell. Did he need c-spine NOPE

The research is here and shows hard evidence of C-spine not required in most instances. But we still have the old school practicioners who still do not welcome change.

 

[Christopher]

I need help settling an argument. How many straps are REQUIRED on a long spineboard? Citing your source would be great!

I don't have to cite any sources when I say this, "there is no known requirement for how many straps are required when using a long spine board."

Why? Because there isn't any decent literature to support any other statement.

You could reasonably state only that the minimum number of straps required may vary per patient, but something like 3 or 4 serves as a floor. However, this is only "expert" opinion and has no known basis in reality or fact

I would say if you do believe in the magical long spine board immobilization fairy (same evidence base as the Tooth Fairy, Santa Claus, or the Easter Bunny) that if 4 straps is good, 5 straps is better, 8 straps is amazing, and 9+ straps is clearly the best.

Are we suffocating them? Probably. But I'll be damned if I let their spine move even a millimeter! Wouldn't want to make a bunch of quads because I was scared of a little respiratory insufficiency.