Spinal Injury Trampoline Extrication

Shelby Stotts

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Hi all!

Recently during a CE course the instructor told a story of having to extricate someone from a trampoline who had fallen on their neck and was experiencing tingling and numbness in the limbs. How would you handle this situation? It would be difficult to get enough people on the trampoline to log roll the pt. without the trampoline collapsing. The instructor didn’t specify how they did it. But said they considered using a basket on a heli. Thanks!
 

VFlutter

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A basket on a helicopter.....Ya, no.
 
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VentMonkey

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How would you handle this situation?
Very carefully. An absolute take your time scenario.

Seriously, with the high index of suspicion for a true SCI, I’m sure as many hands on deck to move the patient safely off of the trampoline without the ridiculously wasteful resource of a helicopter hoist rescue would be sufficient.

Just out of curiosity, was this instructor a fyreMAN-medic?
 

PotatoMedic

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Know that there will be some movement but the major inhury has occurred and that the patient is usually self splinting well. I would just send three people. One to place a c collar and hold the head. And the other to to place a clam shell/scoop stretcher to extricate the patient. Then place them on my gurney and removed the clamshell and transport to the ER with a possible SCI. But that is also working with my spinal protocols.

Also to note once the person is on the clamshell i can send more people to help drag the person off the trampoline or whatever.
 

DesertMedic66

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Depending on how tall the trampoline is you could possibly slide the gurney under it and raise it up (if you have a powered one) under the patient. That would cause the part of the trampoline where the patient is to be stable and would provide support as you move the patient to whatever device your agency approves.

Please don’t use a helicopter for that
 

Peak

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Yeah, I'm gonna vote no helicopter.

How worried am I about musculoskeletal injury? Without serious risk factors the patient most likely hyperflexed their neck and stretched their spinal cord without bone or ligament involvement. I would place a C-collar on the patient and then use a scoop (which is over kill but keeps that license intact) to move them to the cot for transport.

I like @DesertMedic66 idea of the power stretcher. Depending on the construction type and surroundings you could potentially use fire to lift the trampoline, remove the legs, and then lower the trampoline to the ground. Or just be careful and accept the fact that emergencies happen in austere conditions and that a perfect extrication may not be possible.
 

Akulahawk

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These days I'd suggest, as @DesertMedic66 suggests, use a power cot under the trampoline to support the patient. The hard part is how to very slowly put a c-collar on the patient first without causing too much movement. If you can't do that, then just proceed very slowly to minimize movement. Once both are in place, just cut the trampoline around the patient and lower the patient down and out from under the trampoline. If gaining access under the trampoline isn't possible, then the next best option is a c-collar and scoop stretcher to extricate the patient off the trampoline.

As far as MSK injury goes, I would also be worried about posterior neck ligament tears from hyperflexion which could stretch the spinal cord, causing microtears there. In any case, the key thing is being very smooth while working slowly and deliberately around and on the trampoline. The situation and available equipment would basically dictate the specific response necessary.
 

Tigger

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How would using a helicopter even help...you still have to put the patient in the litter.
 

PotatoMedic

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And I just ran a call for a person injured on a trampoline.
 

PotatoMedic

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DrParasite

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But said they considered using a basket on a heli.
So was he calling for the helicopter simply for the basket? because many FDs have stokes baskets on their heavy rescues. or was he calling for the helicopter to lower their the basket to lift the person off the trampoline? which sounds like a really really bad idea, and a huge waste of resources.... but it would look awesome on the news.

thinking of the giant indoor trampoline parks (which are popping up everywhere), this idea doesn't seem farfatched, or that complicated. walk on the edges of the trampoline (they typically don't bounce), and walk to the closest edge to the patient. thank slowly and carefully walk to the patient on the bouncing part. if you want to minimize bounce, slide to the person until someone can stabilize the patient manually, then slide the board to that person and have the other two go assist.

or even better, take 2 LSB, put one from the edge to the patient, walking on it to minimize the bouncing. use second board to secure patient. once secured, carry off. try not to drop the patient.
 

Shelby Stotts

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Very carefully. An absolute take your time scenario.

Seriously, with the high index of suspicion for a true SCI, I’m sure as many hands on deck to move the patient safely off of the trampoline without the ridiculously wasteful resource of a helicopter hoist rescue would be sufficient.

Just out of curiosity, was this instructor a fyreMAN-medic?
Thanks for the reply! And yes, he was certainly more MAN than MEDIC :D
 

Shelby Stotts

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Know that there will be some movement but the major inhury has occurred and that the patient is usually self splinting well. I would just send three people. One to place a c collar and hold the head. And the other to to place a clam shell/scoop stretcher to extricate the patient. Then place them on my gurney and removed the clamshell and transport to the ER with a possible SCI. But that is also working with my spinal protocols.

Also to note once the person is on the clamshell i can send more people to help drag the person off the trampoline or whatever.
Thanks for the reply! Was very interested to hear thoughts on this. I'm a new EMT and my class basically never used a scoop stretcher, the instructors weren't the best.
 

Shelby Stotts

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Depending on how tall the trampoline is you could possibly slide the gurney under it and raise it up (if you have a powered one) under the patient. That would cause the part of the trampoline where the patient is to be stable and would provide support as you move the patient to whatever device your agency approves.

Please don’t use a helicopter for that
Yeah I agree I think the helicopter was either a poorly executed joke or a PR stunt.
 

johnrsemt

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roll the power stretcher under the patient, raise the stretcher until the pt. is being supported by it, then cut the trampoline matt around the stretcher, lower the stretcher and C-Collar the pt. and lower the stretcher and roll the cot out from under the trampoline.

Had one 15 years ago or so: older trampoline that hadn't been used and was dry rotted. 1st time a 19 year old jumped on it, after 2 bounces both legs went through the mat, broke when the hit the ground, when we arrived he was standing up, half supported by the matt, and everytime the trampoline moved his broken legs would bounce against the ground. That was fun
 
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