Preferred method of head immobilization

[Jeremy89]

What do you want them for?

How often will they be used?

What will they be used on?
...

Alright Sean, correct me if I'm wrong, but I believe we'll be running an average of 2-3 calls/day. What will they be used on?? perhaps a patient? lol. unless you were referring to a different post.

Will you be running mainly trauma calls with a lot of fluids where cleaning the equipment will be difficult, or do you need quick turn around times where you cant spend the time to clean Velcro properly?

Not likely, however, we will be dispatched at the same time as the FD/ Ambo co. From my experience (listening to a scanner... haha) they are usually within a mile of us, so our actual patient contact time is going to be relatively short.

Again, you'll have to ask my Chief, Sean for more info

Jeremy

 

[Scout]

No my ideal choice would differ between, say alot of football match injuries and a drunk with an open head wound prone to vomiting. For the latter a disposible would be preferential.

 

[Jon]

We use the roll ones and the disposable straps at work, and we use the reusable foam blocks and reusable speed-clip straps at the volunteer squad.

For motion restriction, you can't beat spider straps, especially if you've got a long carry. They are what I use down at scout camp.


As for CID's... I think the speedblocks are really stable and adjustable, and some of the local services use them. The foam rolls aren't that different from the old-school "towel roll"... they are just made of foam.

 

[seanm028]

No my ideal choice would differ between, say alot of football match injuries and a drunk with an open head wound prone to vomiting. For the latter a disposible would be preferential.

Let's just say that we'll only be running calls on the campus of Arizona State University...

Not likely, however, we will be dispatched at the same time as the FD/ Ambo co. From my experience (listening to a scanner... haha) they are usually within a mile of us, so our actual patient contact time is going to be relatively short.

Correct. However, since we'll be responding on bikes, we will not be carrying the back board to every call. We'll only have c-collars, and we'll have to wait until FD/ambo arrives to backboard. Our backboard will mainly be used for standby events - sporting events, concerts, etc.

 

[medicdan]

The service I work for now carries the disposable yellow head blocks (Head-on)-- which I abhore. They are never firm enough, completely block the patient's hearing, but for services that cant expect to get equipment back, or doesnt board often, they make sense.

I have tried a few different types of head immobilizers, and actually like the stock foam blocks a lot. In order to work well, the velco needs to be clean, and the straps new.

Speaking of the HALO, my partner was telling me about a call he attended to for a patient he had cared before, about three weeks before after a DUI rollover MVA. The patient ended up with a cervical fracture, and a HALO was applied. Two weeks after the accident, the patient had been discharged home, drank again with a friend, who he asked to remove the HALO device, which he did. The same EMS crew was called and found him with just the head ring, lying in bed, at the top floor of an apartment building, where they were unable to remove him on a long board. They ended up calling MedCon, and found the trauma surgeon on call to be the same one who installed the HALO. This surgeon got in his POV and came to the scene to try to reattach the HALO, but ended up helping them collar and board the patient again.

People are really that stupid.

 

[jochi1543]

We have reusable blocks on our ambulance. In class, we use those and also the blanket rolls. I've never come across the other 2 types.

 

[Outbac1]

We use the resuseables. They appear to be fairly durable and not too hard to clean, usually. When I did my first training we used rolled flannels and tape. One seems to work as good as the other.

 

[lightsandsirens5]

We use the reusable ones but we take them off that pad that goes under the head and just tape them down. And we dont fold the tape over. How do people get away with that!?! I'd much rater have my eyebrows ripped off than be paralysed! Also another ambulance service in my area uses the ones in the second pic and I HATE them!

Also, how can anyone hate spider straps?:wacko:

 

[Scout]

L&S why not use the straps provided,


I would freak if i saw someone had tape over their eyebrows. If i resort to tape you get a 4x4 between the tape and you, i cant see how improving pt comfort has an effect on you being any less secure. strapping their eyebrows with duck tape is borderline reportable,, if not 9 yards past it.

 

[lightsandsirens5]

L&S why not use the straps provided,


I would freak if i saw someone had tape over their eyebrows. If i resort to tape you get a 4x4 between the tape and you, i cant see how improving pt comfort has an effect on you being any less secure. strapping their eyebrows with duck tape is borderline reportable,, if not 9 yards past it.

Well, the pt is not supponed to move their head at all. Just a little more secure with a small price to pay.

 

[medicdan]

I'll say this. I have seen in less traditional EMS situations (wilderness) some really cool head immobilizers out of everything from sleeping bags to sleeping mats, water bottles, hip straps on bags, etc, and those were the "mainstream" ones. If EMS weren't so sue-happy, it would open up the market for more comfortable, useful, and streamlined head immobilizers.

 

[frogtat2]

C-Spine immobilization

I looked at the pictures you had, and I have only seen one of them used in this area, by a different ambulance service.

When we have to c-spine someone, we try to place them in a rigid plastic cervical collar. Unfortunately, they don't always feet everyone, even when you have the adjustable ones. We have "towell rolls" that we use. We take two bath towells, roll them up and tape them so they stay in the shape of a roll. This are really effective. Place them next to the patients ears, tape them down, and you are good to go. Added to that, if you have a small patient, you can use a single towell for a smaller roll instead of a 2 towell roll. We use this 100% of the time. Even when we are able to get a c-collar on the patient, we use the towell rolls.

 

[Lin57EMT]

Head blocks

We use the reusable orange or yellow foam blocks. They come with head and chin straps that are also padded, and there is a foam and velcro head pad that attaches to the backboard. The foam blocks attach to the head pads with velcro as well.

The head pads are always on the backboards ready to go, so we don't have to strap one on each time. The blocks are very easy to clean, and their heavier weight and large velcro field makes them feel pretty stable once attached. Their drawback is they can easily be punctured, rendering them unable to be sanitized properly. They need to be checked regularly for tears or holes.

Of course, they aren't perfect for every patient. In fact, today I used rolled towels and a sheet because the patient had scoliosis of the spine and was unable to lay flat on the backboard. We modified to fit the patient, padded gaps and then secured her with conventional straps.

Regarding straps, I prefer the Spider Straps unless we're off the road where the velcro picks up all kinds of grass and weeds. I've never used the disposable velcro type that someone mentioned, but my guess is I would like them as well.

 

[KEVD18]

they're all crap and i have no preference between types of crap.

the only preference i have is the amount of headaches each type causes(to me). all of the reusable one have to be retreived from the er, clead and put back in service. this is a pain, as i have yet to work for service with a dedicated materials person(save for the odd light duty employee). so my only preference is disposable.

 

[NolaRabbit]

We use #3, the roll-type, and they are godawful. Out of all the ones listed in the poll, I think this is the worst choice. They just don't work.

 

[redcrossemt]

Maybe I missed it, but how about talking with the responding fire department to see what they use? If you use the same thing, maybe they'll trade you one when you give them a backboarded patient...

 

[BossyCow]

We use #3, the roll-type, and they are godawful. Out of all the ones listed in the poll, I think this is the worst choice. They just don't work.

I just got some samples of these to try. What are your issues with them specifically. I haven't even taken them out of the box yet so I'd like to hear comments from those who have used them.

 

[KEVD18]

I just got some samples of these to try. What are your issues with them specifically. I haven't even taken them out of the box yet so I'd like to hear comments from those who have used them.

ive used them. my own personal qualms about cspine stuff aside, they arent any worse than any others if used properly.

 

[redcrossemt]

I just got some samples of these to try. What are your issues with them specifically. I haven't even taken them out of the box yet so I'd like to hear comments from those who have used them.

I like the styrofoam roll type. They work like towels. Tape them down good and you're all set. However, they're not very soft or conforming, so consider using towels or other padding with them to fill voids and provide comfort.

 

[Buzz]

I just got some samples of these to try. What are your issues with them specifically. I haven't even taken them out of the box yet so I'd like to hear comments from those who have used them.

We use them here too. I don't have any problems with them, other than bystanders seeing the rolls on our cot and thinking we're bringing some toilet paper along with us ^_^