Who's doing the NY spinal protocols already?

[adamNYC]

Did a board and collar MVA couple weeks ago when I didn't do my spinal yet because pt cc of back pain. When my volly supervisor found out he wasn't happy about it. Doesn't the spinal go into effect December 1st? Anyway, I did my spinal last week and won't dare the use the board again, unless it's for quick transfers and never for txp.

Also seen hatlozah recently at a ped struck they boarded and collared as usual and txp. In fact one of them was asking me about the spinal protocols because he didn't do it yet.

How's it going for you guys

 

[BASICallyEMT]

I have been away for a bit so don't laugh! Did NYC get rid of all spinal precautions? We have a new modified protocol where u use your own judgement about using a board or collar.

 

[Ewok Jerky]

Did you buff that MVA?

 

[RedAirplane]

How did Hatzolah end up at a pedestrian accident? Don't they operate separately from 911 and the volunteer buffers?

 

[adamNYC]

They probably buffed it. I was working a volly as well. We were the first ambulance there and they had like 4 POVs with emergency lights, some of them medics too. Insisted their ambulance is on the way and they would be txp. And yes they did txp. Their bus along with FDNY EMS showed up around the same time.

Smh

 

[RedAirplane]

They probably buffed it. I was working a volly as well. We were the first ambulance there and they had like 4 POVs with emergency lights, some of them medics too. Insisted their ambulance is on the way and they would be txp. And yes they did txp. Their bus along with FDNY EMS showed up around the same time.

Smh

Facepalm. POVs. Also, most regulations I've read indicate that a higher level of provider (and having an ambulance makes you a higher level since you can move) MUST get patient command if they ask for it.

 

[Tigger]

Facepalm. POVs. Also, most regulations I've read indicate that a higher level of provider (and having an ambulance makes you a higher level since you can move) MUST get patient command if they ask for it.

Generally speaking a paramedic will be in control of any scene he or she is present on regardless of their mode of conveyance.

 

[RedAirplane]

Generally speaking a paramedic will be in control of any scene he or she is present on regardless of their mode of conveyance.

I missed the part about some of them being medics.

Disregard what I said.

 

[graycord]

How did Hatzolah end up at a pedestrian accident? Don't they operate separately from 911 and the volunteer buffers?

Hatzolah buffs a lot of calls that are in their neighborhoods.

 

[46Young]

Did you buff that MVA?

I just spit out my drink all over the keyboard, thanks a lot

 

[46Young]

What is the new NY spinal protocol? For a few years we've been able to go with a just a collar, or nothing at all depending on pt presentation. We can also have them self-extricate instead of doing. KED or sliding a board under their butt and inevitably contortions them (defeating the purpose) when getting them flat onto the board.

 

[adamNYC]

Board use for txf only not for txp. Collar use is good. And no standing take downs. Ked can be used but must be removed prior to txp.

 

[EpiEMS]

What is the new NY spinal protocol? For a few years we've been able to go with a just a collar, or nothing at all depending on pt presentation. We can also have them self-extricate instead of doing. KED or sliding a board under their butt and inevitably contortions them (defeating the purpose) when getting them flat onto the board.

NYS continued to be way behind the times for spinal "immobilization." The New York State Emergency Medical Advisory Committee even prevented (for a time, until they came in line with reality) NYC REMAC from eliminating BB & KED.

 

[46Young]

Board use for txf only not for txp. Collar use is good. And no standing take downs. Ked can be used but must be removed prior to txp.

Suprising - studies have shown that when the patient self-extricates, they will guard/minimize painful movement when they move from the seat to the cot. More undesired movement occurred when providers were applying the KED, or when they were moving the patient in-line with the LSB inside the car. The surprising part is removing the board when they're on the cot (for txf only not for txp), since that's even more movement. Would you happen to know the rationale for the current NYS SMR protocol? Could you please post a link to their protocol?

 

[46Young]

http://thesocialmedic.net/2015/03/nyc-remac-eliminating-backboards-from-spinal-immobilization/

Got my answer for the removal of the LSB. Makes sense, since those thing cause more injuries than they prevent. We just try to stay with the collar and low semi-fowler's, or have the pt. refuse the board if we were supposed to use it.

"Extrication of and conveyance of patients may be accomplished with a rigid longboard, but should be
removed via logroll maneuver with manual inline stabilization after the patient is moved to the EMS cot/stretcher. Patients in extremis may remain on the rigid longboard to expedite rapid transport.
The following patients, without evidence of spinal injury, have greater risk of harm than benefit if restrained to a rigid longboard:"

 

[RedAirplane]

At a recent talk I went to, a researcher in spine injuries, athletes, and management and transportation of these injuries suggested that the log roll isn't a great idea. There's some sort of scoop method that actually works a lot better.

 

[Flying]

At a recent talk I went to, a researcher in spine injuries, athletes, and management and transportation of these injuries suggested that the log roll isn't a great idea. There's some sort of scoop method that actually works a lot better.

Scoop. Stretcher?

 

[Smitty213]

Old spinal protocols were technically out the window October 31st with whole month prior being the "transition period", though many people simply just stopped boarding in October. However, as far as your volly supervisor being mad about you boarding someone, legally you are not wrong as the state will continue to defend your malpractice should you choose to continue this particular tortu-, I mean treatment.

 

[RedAirplane]

Scoop. Stretcher?

Some sort of sit-pick with multiple people all grabbing the patient.

 

[Tigger]

Some sort of sit-pick with multiple people all grabbing the patient.

Yup. Someone controls the head and other providers surround the patient and lift vertically. Some sort of transport/immobilization device is then placed under the patient and the patient is then moved on that. Pretty easy and definitely smoother than a log roll, though it makes inspection of the back more difficult. It is the National Association of Athletic Trainer's recommendation as well.