Recovery Position

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CPRinProgress

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I work as a lifeguard but I am also an EMT. We were training where I work as a lifeguard and my supervisor asked me a question out of a lifeguarding book. Here is the question.

You are working as a lifeguard and you walk into a maintenance room and find a maintenance worker laying supine on the ground unresponsive but breathing. He is laying at the base of a ladder. You must leave to get help. What should you do?

The two answers I was between were

Leave him how he is and get help

Place him in recovery position and then leave to get help.

I picked to leave him how he was but my supervisor said the right answer was to place him in recovery to keep his airway open. I thought that since he was laying at the bottom of the ladder, he may have a spinal injury and since he was breathing on his own, I thought it would be best to leave him and then come back and administer care. Am I right in my thinking or am I wrong?
 
I'd side with you, the fact that he's at the base of the ladder at least raises the possibility of a trauma MOI, and thus I wouldn't go moving him about.

I was going to say that it's a matter of scope and training, that lifeguards don't deal with spinal precautions and thus wouldn't be tested on it, but back when I did my lifeguard, we totally covered what to do if someone dives headlong into the bottom, did you?

Of course, the real answer is grab your cell phone and call 911, get a truck rolling for a man down, put the operator on speakerphone and do a rapid assessment to see if you can give them a bit better information.
 
Yes. We are only trained to deal with spibak injuries that occur in the water and they teach us how to do a standing takedown. We do not, however, learn how to log roll if someone is laying on the ground. We are supposed to call EMS and let them handle that. I figured it wasa scope of practice thing I was just surprised that they would put the whole thing with the ladder in if they didn't seem to care about the possible trauma.
 
You're supervisors logic is this: ABC C-spine

My phone is dyingg or id go into more detail but someone will be along to do it.
 
rmabrey said:
You're supervisors logic is this: ABC C-spine

My phone is dyingg or id go into more detail but someone will be along to do it.
Click to expand...

I understand that airway trumps spinal but the question stated they were breathing so the airway is open. I guess it is possible for it to close but in the time it would take to leave and tell someone to call 911 and return, that doesn't seem like it would affect the pt.
 
That's a pretty silly question. Is he not maintaining his airway? Snoring resps? Gurgling? Then leave it be for the 30 seconds it takes you to get help.
 
Can't you put someone in recovery position with their arm supporting their head thus "maintaining" c spine? Modified recovery or lateral recumbant or something?

As for test questions ALWAYS remember A>B>C, always always always, even when it don't make sense.
 
teedubbyaw said:
That's a pretty silly question. Is he not maintaining his airway? Snoring resps? Gurgling? Then leave it be for the 30 seconds it takes you to get help.
Click to expand...

It is from a LG book so it didn't go into that much detail but I'm assuming when they say he is breathing, they mean adequately.
 
beano said:
As for test questions ALWAYS remember A>B>C, always always always, even when it don't make sense.
Click to expand...

I've actually been hearing a lot of C(spine)>A>B>C lately, as C-spine positioning literally makes or breaks your airway.

My cell phone would be on the deck with 911 dialing on speaker.
 
beano said:
Can't you put someone in recovery position with their arm supporting their head thus "maintaining" c spine? Modified recovery or lateral recumbant or something?

As for test questions ALWAYS remember A>B>C, always always always, even when it don't make sense.
Click to expand...

I'm not sure about the recovery position that maintains c spine. My point is that if they are maintaining their own airway at that time, then why compromise cspine unnecessarily.
 
HAINES position.*

If someone can't get out of supine position (unconscious, spine board, paralyzed) you need to protect their airway.

*I am seeing two versions. The one I teach at ARC has both knees bent on completion. All the non ARC stuff I see has only the upper leg bent. The deal is holed the head while turning from supine to semi-prpone and wind up with the head held in approximate alignment with shoulders on top of the lower humerus.
Here's one:
http://www.youtube.com/watch?v=WUHSBsxNJ-Y
 
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mycrofft said:
HAINES position.

If someone can't get out of supine position (unconscious, spine board, paralyzed) you need to protect their airway.
Click to expand...

Thank you mycrofft. I don't remember that from EMT class. The question was after I had taken my recert for LG but I didn't take the first aid portion of the class because they let me skip it since I am an EMT. I guess I should have attended it. Haha
 
I edited the comment as you posted.
It is basic ARC first aid. ;)
 
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What if your patient has a head injury and starts vomiting while you're gone?

Life over limb. Being able to breath is far more important than being able to feel your toes. Roll to recovery if you have to leave.
 
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mycrofft said:
Long time
Click to expand...

OK. Well thank you for the quick reply. I thought it was weird that the question would include the part of the ladder if they just expected lifeguards to disregard the possible spinal injury.
 
CPRinProgress said:
OK. Well thank you for the quick reply. I thought it was weird that the question would include the part of the ladder if they just expected lifeguards to disregard the possible spinal injury.
Click to expand...
You're not "disregarding" the possibility of spinal injuries. You're expected to consider spinal injury and prioritize appropriately.
 
zsstop and read all replies. I'll stop editing mine! ;)
 
CPRinProgress said:
I work as a lifeguard but I am also an EMT. We were training where I work as a lifeguard and my supervisor asked me a question out of a lifeguarding book. Here is the question.

You are working as a lifeguard and you walk into a maintenance room and find a maintenance worker laying supine on the ground unresponsive but breathing. He is laying at the base of a ladder. You must leave to get help. What should you do?

The two answers I was between were

Leave him how he is and get help

Place him in recovery position and then leave to get help.

I picked to leave him how he was but my supervisor said the right answer was to place him in recovery to keep his airway open. I thought that since he was laying at the bottom of the ladder, he may have a spinal injury and since he was breathing on his own, I thought it would be best to leave him and then come back and administer care. Am I right in my thinking or am I wrong?
Click to expand...

The recovery position, or HAINES position, is fine for any patient. Lateral "immobilization" is common in places that actually read good and stuff. Supine is unnatural, impairs pulmonary function, and opens your patient up to the risk of aspiration.

We've got some sick fetish whereby we lay everybody down supine who is sick or injured...can I get some head elevation please? Won't anybody think of the side sleepers?!
 
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