Better c-spine?

[Epi-do]

Originally Posted by karaya

Not God as much as that is how you were taught. The fact is that for now at least, c-spine immobilization is the current standard of care. Exception of course to EMS providers that have adopted c-spine clearance protocols.

Ahhh.....if only that were true. I have selective c-spine protocols and was recently informed that "We have always boarded every MVA patient. It's how we do things around here. Since it doesn't hurt anyone to be put on a board, if I tell you to do it, you will do so." (Told to me by the EMT-B that is the officer at my station, hence, dictating which ALS protocols I can & cannot use. And that is just the very beginning of the issues I have with that statement.)

[Seaglass]

Originally Posted by Epi-do

Ahhh.....if only that were true. I have selective c-spine protocols and was recently informed that "We have always boarded every MVA patient. It's how we do things around here. Since it doesn't hurt anyone to be put on a board, if I tell you to do it, you will do so." (Told to me by the EMT-B that is the officer at my station, hence, dictating which ALS protocols I can & cannot use. And that is just the very beginning of the issues I have with that statement.)

That's really bad. Around here, level of training+experience=authority. So you might find a basic who's had more extrication training telling everyone how they're going to get someone out of a car, but you'd never find a basic telling a medic what sort of care a patient will receive.

[Seaglass]

Quick update: I've been asking around about this offline, and everyone says they get worn out within several minutes, especially with a patient who keeps trying to move or a situation that forces the person holding c-spine into an awkward position. Apparently I'm also often getting stuck with it more often because I'm smaller, stronger and/or more flexible than many of our other basics or first responders, and because I don't do a whole lot of complaining...

[JPINFV]

Originally Posted by Epi-do

Ahhh.....if only that were true. I have selective c-spine protocols and was recently informed that "We have always boarded every MVA patient. It's how we do things around here. Since it doesn't hurt anyone to be put on a board, if I tell you to do it, you will do so." (Told to me by the EMT-B that is the officer at my station, hence, dictating which ALS protocols I can & cannot use. And that is just the very beginning of the issues I have with that statement.)

Serious question. How did you keep from laughing to his face during that?

Second quick question. You did kick that up to your paramedic supervisor, right?

[Seaglass]

Originally Posted by Epi-do

Since it doesn't hurt anyone to be put on a board...

Missed that the first time around. That guy needs to be boarded and left for a good long while before saying it doesn't hurt...

[Epi-do]

Originally Posted by JPINFV

Serious question. How did you keep from laughing to his face during that?

Second quick question. You did kick that up to your paramedic supervisor, right?

Actually, laughing didn't even cross my mind. I was just so utterly frustrated with the entire thing. It doesn't matter what sort of evidence you give this guy to support your stance, he just looks at it, basically says "oh, that's nice", and then tells you that it is going to be his way regardless of what you have to say.

I really want to take this further, but I have spent more time in this guys office in the last 6 months or so than I have with all the other officers/supervisors I have had in the last 10 years. There is a major personality clash there when it comes to patient care/doing the job. I don't want to be labeled a trouble-maker because of this guy, so I am sort of in limbo at the moment.

Originally Posted by Seaglass

Missed that the first time around. That guy needs to be boarded and left for a good long while before saying it doesn't hurt...

I did tell him that even though there may not be any permanent damage done, there is pain caused by being on a board, that soft tissue damage begins to occur after 30 minutes that can ultimately lead to pressure ulcers, and some of the other studies out there. He just blatantly ignored that portion of the conversation.

[RyanMidd]

Originally Posted by Epi-do

there is pain caused by being on a board, that soft tissue damage begins to occur after 30 minutes that can ultimately lead to pressure ulcers,

I've had to board several MVC and vehicle vs. wildlife patients. I know 2 of them personally, and they have quarter-sized bald spots on their occipitus from being on the board for...wait for it....less than 2 hours each.

Any small amount of movement, jostling, or friction causes tissue damage. I agree with whoever said that supervisor needs to be boarded and transported from a remote location.

[Seaglass]

Originally Posted by RyanMidd

I've had to board several MVC and vehicle vs. wildlife patients. I know 2 of them personally, and they have quarter-sized bald spots on their occipitus from being on the board for...wait for it....less than 2 hours each.

Yikes--I've never encountered that. Guess our county's head beds aren't so awful after all, or maybe my scalp is just more resilient than most. I was boarded for about six hours once, and just came away with massive bruising and a week where I could barely move. I remember it hurting a bit, but the injury that put me there was way worse, and my LOC wasn't the greatest at the time.