Backboarding a Hip fx

[jaksasquatch]

Backboards are not spinal immobilization devices, they're extrication devices. You can choose to add head blocks, tape, towel rolls, a C-collar, spider straps, 9 foot straps, perhaps even a head bed...but it still has nothing to do with immobilization.

Once you separate your terminology to remove this confusion, the answer becomes obvious.

Rolling your hip Fx patient is going to be awful, sliding your hip Fx patient is going to be awful. Whatever you choose, you must limit both of these actions.

If you had some indication for spinal motion restriction, you should continue through whatever your procedures are for SMR.

If you have no indication for spinal motion restriction, you should continue through whatever your procedures are for moving a patient with a hip Fx.

You probably have a device which can satisfy both the Brothers Grimm and your patient's hip Fx: the scoop stretcher!

Got ya, using it as an extrication device on a hip fx (saying you don't have a scoop stretcher) what strapping technique (hi/low, pchute etc...) would one want to use?

 

[Christopher]

Got ya, using it as an extrication device on a hip fx (saying you don't have a scoop stretcher) what strapping technique (hi/low, pchute etc...) would one want to use?

Not a fun prospect if that is all you have. Perhaps if you carry a KED you can slide that upside-down, underneath the hip first.

If you lack the KED, my suggestion would be what most of the others have echo'd. Blanket wrap first, pad the mess out of your backboard, then do a lift-and-slide technique to inch the backboard under them; such that they're not moving but the backboard is.

This is my go-to guide for illustrations of the many different ways you can successfully lift/move patients.

 

[Tigger]

It has a shortened limb. Most hip fractures are actually an upper femur. With the shortened limb this sounds like an actual femur.

That alone should not be reason to apply a traction splint. Placing a Hare type splint a patient with proximal femur fracture, especially on the femoral neck, can be extremely painful for the patient. The anchoring ischial strap can cross the fracture site so when you pull traction the patient is going to be in even more pain.

Other traction splints (Sager, etc) can also have these issues.

Also most hip fractures are not just an upper femur fracture, I'd check your sources on that one.

 

[Mariemt]

That alone should not be reason to apply a traction splint. Placing a Hare type splint a patient with proximal femur fracture, especially on the femoral neck, can be extremely painful for the patient. The anchoring ischial strap can cross the fracture site so when you pull traction the patient is going to be in even more pain.

Other traction splints (Sager, etc) can also have these issues.

Also most hip fractures are not just an upper femur fracture, I'd check your sources on that one.

Without being there and seeing I have no way of knowing. The hip fractures thus far have so far resulting in feet turnung and limb elongation.

Applying the traction splint on my pts with the upper femur fracture has provided much relief.

 

[mycrofft]

Backboards are not spinal immobilization devices, they're extrication devices. You can choose to add head blocks, tape, towel rolls, a C-collar, spider straps, 9 foot straps, perhaps even a head bed...but it still has nothing to do with immobilization.

Once you separate your terminology to remove this confusion, the answer becomes obvious.

Rolling your hip Fx patient is going to be awful, sliding your hip Fx patient is going to be awful. Whatever you choose, you must limit both of these actions.

If you had some indication for spinal motion restriction, you should continue through whatever your procedures are for SMR.

If you have no indication for spinal motion restriction, you should continue through whatever your procedures are for moving a patient with a hip Fx.

You probably have a device which can satisfy both the Brothers Grimm and your patient's hip Fx: the scoop stretcher!

Lemme hear the choir repeat, "extrication device"!
Amen!

Then, once out, how to minimize leg movement and motion to hips?
Scoop is much like a LSB but not as effective as immobilization.
Don't logroll pt onto the board; use clothing or weasel a bedsheet or whatever (thin transfer plastic board?) under to raise her as LSB or KED is slid under.

 

[jaksasquatch]

Not a fun prospect if that is all you have. Perhaps if you carry a KED you can slide that upside-down, underneath the hip first.

If you lack the KED, my suggestion would be what most of the others have echo'd. Blanket wrap first, pad the mess out of your backboard, then do a lift-and-slide technique to inch the backboard under them; such that they're not moving but the backboard is.

This is my go-to guide for illustrations of the many different ways you can successfully lift/move patients.

Love that book, makes it pretty obvious. Do you have any other resources like that on basically any topic EMS? I'm like a 3 yr old, I love picture books

 

[unleashedfury]

I've used the scoop a few times to accommodate the patient with an hip fracture. I've heard of the KED vest method. But I have yet the opportunity to try it..

 

[mycrofft]

Not a fun prospect if that is all you have. Perhaps if you carry a KED you can slide that upside-down, underneath the hip first.

If you lack the KED, my suggestion would be what most of the others have echo'd. Blanket wrap first, pad the mess out of your backboard, then do a lift-and-slide technique to inch the backboard under them; such that they're not moving but the backboard is.

This is my go-to guide for illustrations of the many different ways you can successfully lift/move patients.

I will grab a soda and go through that link's material. I smell pragmatism.

 

[mycrofft]

That alone should not be reason to apply a traction splint. Placing a Hare type splint a patient with proximal femur fracture, especially on the femoral neck, can be extremely painful for the patient. The anchoring ischial strap can cross the fracture site so when you pull traction the patient is going to be in even more pain.

Other traction splints (Sager, etc) can also have these issues.

Also most hip fractures are not just an upper femur fracture, I'd check your sources on that one.

Most cases called "hip fx" are femoral neck fx.

 

[mycrofft]

A hip is not a hipbone.

I've heard the MAST helps with PELVIC fx but not HIP (femoral neck) fx.

Femoral neck fracture ("hip fx").

VERSUS

Illiac fx ("hipbone fx").​

OK, so what you are trying to mininmize are affected leg movement in relation to the pelvis, and jouncing.

This can be done on an ambulance litter mattress with sandbags and tying on sheets or blankets, then driving carefully.

Getting the pt onto and off of it are the challenges.

I would think a traction splint might help with discomfort if there is no pelvic injury.