No C-Spine... Right call?

Medic Tim said:
.....But protocols and what is right for your pt can be at odds with one another. Many thankfully take their education into their own hands and fill the gap.
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There has been, in many cases, a divergence between what is correct and what is right. If a medic knows that the correct thing to do is procedure x for condition y based on outdated standards of care, is it or is it not ethical and moral to do so, especially if it has the potential to harm the patient?

Thinking about LSBs alone, we know it to be dangerous, painful, and of zero benefit. We also know we're bound by protocols. So where do we draw the line? When does applying a protocol because the book says cross the line into unethical territory? I think this is something that EMS lacks....the ability to justify one's actions by the application of ethics. And besides, since when did it ever become okay to say We know this will hurt, but it's for your own good? Pain = stop! No?
 
Dakota said:
honestly, with him being altered and a possible moi like that(blood and teeth on the ground) i would have done full c-spine and ignored the medic
Sorry medic, but thats just a risky call for the patient, and just plain stupid really given the circumstances
Not even a collar? foolish, remember paramedics are individuals, some arent very good, cuz theyre lazy or stupid, same with police, nurses or whatever
they give everyone else a bad name, so we should stop them from making those calls (appropriately), and making us look bad
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Collar and board, all the way to the hospital. How is this even being questioned? Unless you got an MRI in your truck to accurately determine if there are bone fragments around the spinal cord then the collar stays on. Immobolize! Prevent further injury if at all possible. Holy shmokes!
 
68wildcat said:
Collar and board, all the way to the hospital. How is this even being questioned? Unless you got an MRI in your truck to accurately determine if there are bone fragments around the spinal cord then the collar stays on. Immobolize! Prevent further injury if at all possible. Holy shmokes!
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How is this being questioned? Because we started doing this in the 60s after ONE surgeon decided that the reason 29 people had delayed onset paralysis was due to the people that touched them first. No study, no evaluations, just an opinion. In today's world, opinions like that don't hold water and if LSBs were to be introduced today, they would never, ever, ever, ever, be approved for use. I see you are new and on the presumption that you are new to EMS...... always question the status quo. It drives learning, which in turn drives evidence and science based care, which in turn drives better patient outcomes.

For this call, the collar is sensible. The board, however, is not. Instead of hashing it all out again, you can fine plenty of evidence here: https://www.reddit.com/r/ems/comments/33apry/since_we_like_to_talk_about_backboards_so_much/

Of interest, a study was conducted comparing patients from Albuquerque and Malaysia. The USA immobilisation rate was 100%, the Malaysian rate was 0%. ll being equal (demographics, in hospital care, MOI, etc...) the patients from New Mexico had a 21% disability rate. The Malaysian rate was 11%. That's a whopping 10% less.
 
68wildcat said:
Collar and board, all the way to the hospital. How is this even being questioned? Unless you got an MRI in your truck to accurately determine if there are bone fragments around the spinal cord then the collar stays on. Immobolize! Prevent further injury if at all possible. Holy shmokes!
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Please oh please, read the rest of this thread and consider catching up with one or two of the developments in medicine from the past few decades :/
 
highglyder said:
How is this being questioned? Because we started doing this in the 60s after ONE surgeon decided that the reason 29 people had delayed onset paralysis was due to the people that touched them first. No study, no evaluations, just an opinion. In today's world, opinions like that don't hold water and if LSBs were to be introduced today, they would never, ever, ever, ever, be approved for use. I see you are new and on the presumption that you are new to EMS...... always question the status quo. It drives learning, which in turn drives evidence and science based care, which in turn drives better patient outcomes.

For this call, the collar is sensible. The board, however, is not. Instead of hashing it all out again, you can fine plenty of evidence here: https://www.reddit.com/r/ems/comments/33apry/since_we_like_to_talk_about_backboards_so_much/

Of interest, a study was conducted comparing patients from Albuquerque and Malaysia. The USA immobilisation rate was 100%, the Malaysian rate was 0%. ll being equal (demographics, in hospital care, MOI, etc...) the patients from New Mexico had a 21% disability rate. The Malaysian rate was 11%. That's a whopping 10% less.
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You need to start posting here more often haha
 
68wildcat said:
Collar and board, all the way to the hospital. How is this even being questioned? Unless you got an MRI in your truck to accurately determine if there are bone fragments around the spinal cord then the collar stays on. Immobolize! Prevent further injury if at all possible. Holy shmokes!
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I suppose you did not read the six pages prefacing this then....
 
Holy crap someone owning up to their mistakes on this forum? Hell is freezing over!
 
Cool. Thanks for the reply 68wildcat! Now go forth, read the primary sources of research, and share them with others.
 
highglyder said:
Because we started doing this in the 60s after ONE surgeon decided that the reason 29 people had delayed onset paralysis was due to the people that touched them first. No study, no evaluations, just an opinion.
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Which surgeon do you mean?
 
Yep. It goes back perhaps as early as the year before (Kossuth), but along with Farrington the next year Geisler probably published the earliest influential references.
 
with a possible fall of 25 feet and the pt was surrounded by a pool of blood and his teeth. I would of have done a full C-Spine Immobilization.. Board and all
 
Kennedy said:
with a possible fall of 25 feet and the pt was surrounded by a pool of blood and his teeth. I would of have done a full C-Spine Immobilization.. Board and all
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Please read the rest of the thread and take advantage of the available resources to educate yourself.
 
Kennedy said:
with a possible fall of 25 feet and the pt was surrounded by a pool of blood and his teeth. I would of have done a full C-Spine Immobilization.. Board and all
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1371958486502996037.jpg
 
Surrounded by pool of blood and teeth is a great reason for me to not want to board this patient. Unless you want me to RSI them to take control of their airway so you don't kill them with aspirated blood
 
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