Strange stuff on your truck

[TransportJockey]

I am still fine with the KED being on my unit. They work great for hip/pelvis injuries. We carry a pedi backboard so I've never used it for that before.

Since I cover one of our race tracks the KED and a "speed board" make getting drivers out of their specially designed seats much easier.

That last paragraph is literally why the KED exists

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[NomadicMedic]

That last paragraph is literally why the KED exists

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Yep. The KED was designed to hoist the immobilized driver out of the car, using the wrecker. Be careful if you want to rig and lift one now. The knockoffs are not load rated like the originals Kendrick devices.

 

[EpiEMS]

I don't know that I would be all that jazzed about moving a patient I suspect of, say, anterior cord syndrome freely with just SMR.

Clearly, you'd be able to distinguish this more often than not over a whiplash-type injury. Nonetheless, I'm ok with an extra-cautious approach in these types of SCI's.

It doesn't hurt that the backboards are so much more convenient in the helicopter. When you have a chance look up spinal shock as well. While there's probably no way to discern the two in the field, I can't imagine that being any fun, and not worrisome to the patient themselves.

Edit: if I had one of those nifty inflatable doo-hickies that's designed to "splint" the body I'd use that. Does anyone have one, and if so, how do you like it?

Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.

Oh, those vacuum mattresses - I have to wonder how effective they are, but boy, they look comfy!

That last paragraph is literally why the KED exists

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Never actually used it in an MVA...first time I asked about it for a patient where it was indicated (back when we were still boarding and collaring), I was shouted down, so that was fun.

 

[VentMonkey]

Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.

Sure, but I can't buy into the backboard has zero place on an ambulance quite yet. Most, not all won't need it.

I cringe, and snicker at people who full c-spine GSW's, and even worse, stab wounds nowhere near the spinal column.

How "uncomfortable" is it to a completely flaccid patient from T-4 down? It serves as a good reminder to mondo the medic, or fireman to gently move them.

And again, at least in our helicopter, we have a LifeBlanket that has a roll out mover. I would soon rather these SCI patients be on a board (full c-spine, or not) than the flat. The flat takes waaay too much hassle trying to jam it in. We have to lift it up and over, not fun, easy, or proficient with said types of injuries; a KED would be acceptable, too.

 

[EpiEMS]

@VentMonkey, your points are well taken - the abiding concern, of course, is that our precautions may cause more harm than good (as you acknowledged). Absent good data on whether LSB actually adds any benefit, though, we have to be really cautious, and as the NAEMSP statement from 2014 acknowledges:

{I}t is unclear whether spinal precautions, including a backboard and cervical collar, adequately protect those unstable injuries at risk to worsen with minimal movement.

I guess as far as a reminder, that makes some sense. Maybe it's silly of me, but I'm not entirely convinced that a LSB is better for that, say, T-4 injury patient than a collar + scoop --> flat stretcher (for ground ambulance purposes).

 

[VentMonkey]

Sometimes I live life away from stats, and cohort studies. I just do what I feel is right (within protocol). Afterall, I'm a primate.

 

[DesertMedic66]

That last paragraph is literally why the KED exists

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Yep. I haven't had to use it yet... *knock on wood*

 

[EpiEMS]

Sometimes I live life away from stats, and cohort studies. I just do what I feel is right (within protocol). Afterall, I'm a primate.

Haha, don't we all? That said, I am subject to confirmation bias (as you know, I don't like boarding people, so I seek studies that show it to be harmful).

 

[VentMonkey]

Haha, don't we all? That said, I am subject to confirmation bias (as you know, I don't like boarding people, so I seek studies that show it to be harmful).

I hear ya, that said, medicine is so fickle I like to think an excellent practitioner can still employ a bit of common sense to each case specifically, and be willing to both defend, and explain their rationale for what they did.

This can work for either side of the "de we put people on backboards at all anymore" debate, as well as many others, as is displayed by this forums growth.

 

[Tigger]

Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.

Oh, those vacuum mattresses - I have to wonder how effective they are, but boy, they look comfy!



Never actually used it in an MVA...first time I asked about it for a patient where it was indicated (back when we were still boarding and collaring), I was shouted down, so that was fun.

I am yet to find any evidence that shows vacuum mattress are actually capable of immobilizing the spine. Also, our county bought hundreds of the semi disposable kind form Hartwell. Do not do that.

 

[EpiEMS]

I am yet to find any evidence that shows vacuum mattress are actually capable of immobilizing the spine.

I think that's probably true - though I would imagine they avoid some of the adverse effects of boards (e.g. decubitus ulcers, general discomfort)

 

[Tigger]

I think that's probably true - though I would imagine they avoid some of the adverse effects of boards (e.g. decubitus ulcers, general discomfort)

There is evidence of that. But nothing that they actually do anything.

 

[Grozler]

Seriously, what is this thing?

 

[EpiEMS]

There is evidence of that. But nothing that they actually do anything.

That's my sense of the available evidence, as well, for spinal "immobilization" generally.

 

[Tigger]

Seriously, what is this thing?

We'd be screwed without all of our paper national forest/ATV maps. Love me some google maps, but sometimes some map reading skills are the ticket.

 

[NomadicMedic]

Gotta have those USFS and topo maps on your iPad.

 

[Tigger]

Gotta have those USFS and topo maps on your iPad.

That is actually a good idea, once we move on past the motion tablets.

 

[CALEMT]

That is actually a good idea, once we move on past the motion tablets.

PDF maps or Avenza maps is now what's it's call I believe. It has all the 7.5 minute topo maps for free and it doesnt require and sort of wifi or cell service because it's GPS. Comes in real handy for me when I'm out in the woods.

 

[Old Tracker]

Paper maps aren't useless if much of your area does not have cell phone service. Just sayin'.

 

[NysEms2117]

Paper maps aren't useless if much of your area does not have cell phone service. Just sayin'.

Ok. from my useless stuff: 1. a paper map too, 2. a tape 3. green plastic bucket and shovel for kids (I don't have any)

a little land navigation never hurt nobody . *hey lets drop into a random forest and find your way out! GO!*