Spinal Precautions

[Outbac1]

Mostly a long spine board with collar and Ferno head blocks. We have Keds on the trucks but they rarely get used. We also have a pedi board (the name of which escapes me just now), with multiple colored straps for pedi pts. Fortunatly it gets very little use.

 

[Short Bus]

Just to clarify... R/R911 is talking about a Reeves Sleeve - which goes over a backboard and acts in place of the standard CID's and Straps. Proponents say that it does a much better job at immobilizing patients... Detractors say it takes too long to apply (just like the KED).

This works great for low slope evac and combative pt as well. They can not hurt themselves if they are in a Reeves sleeve

 

[Ops Paramedic]

Hi rid!

The mainstay is the LSB with collar, beadblocks, baseplate and spider harnass as mentioned by stones. Sometimes the scoop also has its place, ie if the patient is on the floor outside the wreck, or when doing an ICU transport where the patient is ventilated (I prefer to still fully package). Should you however transfer for a CT scan, we try and use the LSB (Plastic one), that will save you from having to scoop the patient on and off the CT bed. Fot the long distance transfers we will use the vacuum mattress.

The crews this side often cross the head straps for the blocks across the forehead, in stead on one over the chin, and one over the forehead, moreso when there is a c-collar or an O2 mask in situ. Do you guys do the same?

 

[mikeylikesit]

spider starps, long board, c-collar, head blocks and a butt load of tape.

 

[PapaBear434]

Hi rid!

The mainstay is the LSB with collar, beadblocks, baseplate and spider harnass as mentioned by stones. Sometimes the scoop also has its place, ie if the patient is on the floor outside the wreck, or when doing an ICU transport where the patient is ventilated (I prefer to still fully package). Should you however transfer for a CT scan, we try and use the LSB (Plastic one), that will save you from having to scoop the patient on and off the CT bed. Fot the long distance transfers we will use the vacuum mattress.

The crews this side often cross the head straps for the blocks across the forehead, in stead on one over the chin, and one over the forehead, moreso when there is a c-collar or an O2 mask in situ. Do you guys do the same?

I would much rather just use the old standard belt straps than those stupid spider straps. Not only do I have nothing to tie down the hands to keep them from flopping around, but they are a pain in the *** to apply and clean off afterwards.

 

[BossyCow]

I would much rather just use the old standard belt straps than those stupid spider straps. Not only do I have nothing to tie down the hands to keep them from flopping around, but they are a pain in the *** to apply and clean off afterwards.

Cracks me up how dedicated people are to their method of choice. Personally I prefer straps as well, but have heard those who use them often rave about spiders and how they wouldn't use anything else. Precisely why we carry both on our rigs.

 

[mikeylikesit]

we carry all type...and a whole role of duct tape.B)

 

[mdkemt]

Ahh Yes! Never forget the duct tape. Works wonders LOL!!!
We just started to use spider straps here it is nice!

MDKEMT

 

[rescuepoppy]

We mostly use LSB Headblocks and Spider straps. But as always you have to treat the patient or situation so it is nice to have other options and know how to use them. Dont get so hung up on one method that you dont know how to use other things that are at your disposal.

 

[ffemt8978]

Here in BC, Canada (again with this start, huh?) we use the scoop or "clamshell" almost exclusively. Coming from Saskatchewan, I trained on LSBs and rarely used the scoop either.

But here we use the LSB for rapid extrications mainly. We can use the KED as well, but few EMS personnel here do. Anyone well trained with the KED can typically extricate just as quickly with it as those with the LSB.

Just some info on the scoop: it is rated for spinal immobilization now and it is also more comfortable for the pt for extended transfer times vs. the LSB. There is also the option to make up a "bed" of blankets on a #9 and then place the immobilized pt onto, then remove the scoop, and replace the scoop under the blanket bed (holding the blankets taught) and restrap. This is a huge benefit to pts with very long transfer times, especially on fixed-wing transports that get real bumpy.

But I do miss the headblocks of the LSB because they were easier than sandbags rolled in towels and taping (or the ridiculous headbed).

I'm curious as to what the ER thinks of this...

Our LSB's are XRay transparent, but our scoops are made out of aluminum. The ER would have to remove the patient from our scoop to XRay C-Spine to clear it.

 

[Ridryder911]

The reason I asked this question is PHTLS as ITLS, etc. is now suggesting to remember that the scoop type device on patients. It is easy to apply, provides good spinal precautions, etc. Upon ER they can be removed easily as other potential spinal arrangements can be made, as well as the "pressure" concern is removed.

Alike everyone else, LSB is most commonly used because it is more of a habit than thinking of the best device for the patient. Although, I agree I too use it way to often, LSB has very serious complications to patients that have to be on one for an extended period of time (>30 minutes).

Just something to think about...


R/r 911

 

[enjoynz]

We use a Scoop stretcher for suspected spinal injury patients.
We are only allowed to use LSB as an extrication device (Slide),
re our protocols.

Cheers Enjoynz

 

[PapaBear434]

Newbie fresh out of training here. And yeah, scoop stretchers are nice, but we don't use them often. Pretty much only under certain circumstances were we told it was to be used.

1) Expedient move. If you need to move a patient quick due to a hazardous environment like rising water or some such thing, and you don't have enough time to do a proper roll with at least two people, the scoop is nice.

2) Too small for a traditional longboard. Not enough room to get enough people in a small bathroom to roll the patient or something like that.

3) Mud. Mud can be a biatch, and sometimes it's easier to just pull them out. Yes, they specifically taught us mud.

As far as worrying about x-ray, we've been taught to put them onto a traditional board as soon as possible and to remove the scoop from under them. It's too cold and tends to pinch things, and making a trauma patient even more uncomfortable tends to be frowned upon.

 

[traumateam1]

Here in BC, Canada our clamshells are xray transparent so when the p/t is wheeled into the ER, if needed they can go right into xray. Also from training I find that the clamshell is a lot more comfortable for the p/t while still providing good spinal percautions. And I find that the clamshell moves the patient a lot less when packaging.

 

[PapaBear434]

Yeah, ours are cold, stiff aluminum with no comfort factor in mind.

 

[BossyCow]

We just bought the Ferno EXL Scoop. Plastic, light, easy to clean, no x-ray issues. Better attachment for straps. Also warmer and easier to close. Hated the way the clasps worked on the old one. If they weren't lined up perfectly, you couldn't get them to latch.

 

[PapaBear434]

If they weren't lined up perfectly, you couldn't get them to latch.

Here here! Dang I hate those things for that reason alone. Not only is it a pain to deal with it, but if the patient is conscious, they think you are a boob that doesn't know how to work your gear. Last thing you want is for the person you're trying to help to think you incompetent.

 

[Ridryder911]

Over the past 30 years of using the "scoop" I have found two main reasons for having a hard time of closing or fastening scoops.

1) Equipment not serviced. The latching mechanism has to be greased with white graphite, periodically.

2) Really weather is regardless, but one has to gently roll the patient slightly to one side & then another to assure the device is placed correctly. As well, I have found closing the head portion first is much easier.

Alike, any other device, practice is essential. I have found most were more unfamiliar using scoops than LSB. Ironically, since the recommendation I have been using scoops more than LSB on real trauma patients. I can place them onto ER beds and remove them with ease, as well as x-ray tables, flight service stretchers, etc. Remember, LSB may cause more harm than good. Also, I do not loose a piece of equipment.

 

[mikeylikesit]

Alike, any other device, practice is essential. I have found most were more unfamiliar using scoops than LSB. Ironically, since the recommendation I have been using scoops more than LSB on real trauma patients. I can place them onto ER beds and remove them with ease, as well as x-ray tables, flight service stretchers, etc. Remember, LSB may cause more harm than good. Also, I do not loose a piece of equipment.

except when you have to get them in for an MRI ASAP...then you can't bring them in with the patient...but why would you. i like the scoop because it can be done much quicker and with minimal risk to moving the patient for proper placement. the only thing i don't like is with the LSB you get the back exam and the procedure for moving them onto the device all in one sweep.

 

[Ridryder911]

except when you have to get them in for an MRI ASAP...then you can't bring them in with the patient...but why would you. i like the scoop because it can be done much quicker and with minimal risk to moving the patient for proper placement. the only thing i don't like is with the LSB you get the back exam and the procedure for moving them onto the device all in one sweep.

True, usually there is no such thing as an emergency MRI. A CT, etc. is used to rule out before use of MRI, as well they are usually transferred to another device before going to an MRI.

The point I was attempting to make is remember another spinal immobilization device. It has been proven to be more beneficial to the patient, quicker and easier.

R/r 911