Immobilize or not?

[jjesusfreak01]

I would want to know specific MOI. Was he beaten with fists or bats, maybe metal bats or rods? If there was significant MOI, even manual weapons, I might consider c-spine precautions, because a significant beating is likely to be a distracting injury in any case.

 

[HMartinho]

Thank you all for the answers. This is what I like in a forum, everyone can learn from each other.

He was kicked several times. Perhaps the full immobilization was unnecessary, but our protocols are very strict, and in my EMT-B program (a few months ago), we learn to "play safe".

 

[DJRedNight]

Our BLS unit was dispatched for an assault victim on a sidewalk. Male, 19 years old that was beaten several times in his belly, back and chest. He complains pain on his ribs, backaches, headaches and some shortness of breath. He's alert and orientated.

BP: 130-85
Pulse: 98
RR: 15
temp: 36,5 ºC/97,7 ºF
pupils are equal and reactive
pulse-ox: 93% on room air
breath sounds are normal
Pain: 5 on a scale between 0 to 10.

History of tipe I diabetes and allergy to penicillin.

On physical examination (head-to-toe), we don't found nothing of concern.

The question is: I proposed a full immobilization (as I learned in these cases), but my partner did not agree, and said: We don't find nothing special on physical exam,so it is not necessary. After a little reflection, my partner eventually agreed, and the patient was immobilized with backboard, c collar and head stabilizers.

He was transported to the hospital, with 3 liters of oxygen per minute via nasal cannula.

What do you think? We should immobilize or not?

To put it simply, yes. Beatings are considered a trauma situation. You dont know how or where he got hit unless you actually viewed the beating. Immobilization of the spine and neck is KEY and should be treated as a trauma scenario. the means doing DCAPP-BTLS, PMS, HIGH flow oxygen at 15L/min on a NBR, (3L/min on nasual canula just doesn't cut it for 93% SpO2 levels) cutting off clothes if needed and checking for step offs and other misc injuries on his back. I agree with you and not your partner. Sounds like to me you might want to discuss this over with your partner and figure out whos taking charge on calls. Sometimes going OVERBOARD on things is best.

Hell, i boarded someone last week, who was in a minor fender bender at 5 miles and hour in a freaking parking lot. she was 22, and in perfect health. hypochondriac in my opinion... but we did it anyways because she complained of back and neck pain. doesn't matter if injuries are apparent or not or even after palpation. If they say they have back or neck pain. BOARD EM!

 

[Smash]

To put it simply, yes. Beatings are considered a trauma situation. You dont know how or where he got hit unless you actually viewed the beating. Immobilization of the spine and neck is KEY and should be treated as a trauma scenario. the means doing DCAPP-BTLS, PMS, HIGH flow oxygen at 15L/min on a NBR, (3L/min on nasual canula just doesn't cut it for 93% SpO2 levels) cutting off clothes if needed and checking for step offs and other misc injuries on his back. I agree with you and not your partner. Sounds like to me you might want to discuss this over with your partner and figure out whos taking charge on calls. Sometimes going OVERBOARD on things is best.

Hell, i boarded someone last week, who was in a minor fender bender at 5 miles and hour in a freaking parking lot. she was 22, and in perfect health. hypochondriac in my opinion... but we did it anyways because she complained of back and neck pain. doesn't matter if injuries are apparent or not or even after palpation. If they say they have back or neck pain. BOARD EM!

American EMS, I weep for you.

 

[DJRedNight]

American EMS, I weep for you.

I weep for me too. lol

 

[Handsome Robb]

American EMS, I weep for you.

I was thinking the exact same thing.