new york state and spinal immobilization

[nymedic9999]

OK so I know that spinal immobilization is a topic that has been debated over and over again but I have a question that relates to medics in New York state. How comfortable are you as a medic selecting not to immobilize a patient. Say you had a patient who fell of a skateboard and broke there arm with a abrasion to there head, would you be comfortable clearing this if the patient was caox4 had no complaints and a normal physical exam? Even though the patient hit there head?

 

[chaz90]

This exact scenario came up on the forum recently. The answers really won't change whether you're in New York or not. Read through the other threads.

 

[Medic Tim]

OK so I know that spinal immobilization is a topic that has been debated over and over again but I have a question that relates to medics in New York state. How comfortable are you as a medic selecting not to immobilize a patient. Say you had a patient who fell of a skateboard and broke there arm with a abrasion to there head, would you be comfortable clearing this if the patient was caox4 had no complaints and a normal physical exam? Even though the patient hit there head?

head injury or trauma does not = spinal damage

look into nexus and the Canadian c-spine clearance rule. A lot of places are using these as tool.

no board and collar from me

 

[broken stretcher]

No complaints or abnormal findings in the H/N/B region. No neurodeficits in the extremities. Pt CAO. No backboard

 

[firecoins]

I wouldn't

 

[Bullets]

As i try to teach my cadets and probies, there are head injuries, traumatic injuries and then there are Head Trauma.

A papercut is a traumatic injury, but it is not a trauma.

So an abrasion is technically traumatic, it isnt Traumatic.

That said, no LOC, no pain or tenderness on palpation in the Cervical Region, then no board for me and i will defend easily

With the NAEMSP/ACSCOT position, this is easily defensible

 

[nymedic9999]

So where would you draw the line? I have always been taught and my protocols stat that "head trauma" requires spinal immobilization.

 

[Bullets]

So where would you draw the line? I have always been taught and my protocols stat that "head trauma" requires spinal immobilization.

Spinal Pain/tenderness?
Physical Deformity?
LOC/altered?
Distracting injury?

If none of these things are present, then no SMR.

Remember, the purpose of SMR is to restrict the movement of the cervical spine, just as you would splint an arm with a radius fracture to restrict further movement.

Just because they have a head injury doesnt mean they have a spinal injury. Ive treated patients with avulsions on the scalp and forehead who did not get SMR because they had none of the above listed complaints

 

[Tigger]

Just because they have a head injury doesnt mean they have a spinal injury. Ive treated patients with avulsions on the scalp and forehead who did not get SMR because they had none of the above listed complaints

The most important part.