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Home > List Archives

Spine Immobilization

Bjorn, Pret trauma-list@trauma.org
Tue, 15 Apr 2003 06:53:51 -0400


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Jenny,
 
This becomes a semantics exercise.  
 
Where I live, at this time of year, the drive to the hospital is typically
much more violent than the hike out of the ditch.  Frost heaves in Maine can
take an unrestrained driver right out of his seat (an under-appreciated
cause of MVC), so I'm not keen on de-immobilizing a patient with a suspected
neck fracture until he's in a nice, stationary building.
 
Extrication, transport, whatever: splint suspected fractures until external
forces are under control.  Fair enough?
 
You raise Arabians?  Used to have a couple when I was a kid.  Extraordinary
animals.
 
Pret

-----Original Message-----
From: Jenny Moncur [  <mailto:jmoncur@netspace.net.au>
mailto:jmoncur@netspace.net.au]
Sent: Monday, April 14, 2003 10:55 PM
To: trauma-list@trauma.org
Subject: Re: Spine Immobilization



>*********** REPLY SEPARATOR ***********
>
>On 14/04/03 at 7:20 AM Bjorn, Pret wrote:
>

 A long board is NOT A TREATMENT; it is a TRANSPORT DEVICE.

.................................

Pret, I believe that a long board is actually an EXTRICATION device, not a
transport device.

A conscious, compliant patient will be be more comfortable, and hence more
inclined to lie still on a stretcher in the back of a moving vehicle, than
on a rigid board where they will frequently slide up and down in response to
acceleration and deceleration of the car (despite various straps and head
rolls). Speaking from experience (working around horses will give you this),
even a short trip on a spine board is awfully uncomfortable, and makes the
sore bits sorer and the patient more inclined to wriggle.

With regard to the 'sand bag' issue, as a paramedic I use two towels rolled
into a cylinder and wrapped in tape.. Theses rolls are then placed one each
side of the patients head and taped to the stretcher. This then encloses the
head in a soft support, but the patient is not himself strapped down to the
stretcher, avoiding the risk of a fixed head and a non fixed body (pendulum
effect).

Of course, this all applies to the fully conscious, alert and cooperative
patient.

Cheers
Jenny Moncur
IC Paramedic
Victoria
Australia



Jenny Moncur
'Mullungdung Arabians'
Willung South, Victoria

Situated near the beautiful
Mullungdung State Forest in
Gippsland

ph/fax  (03)  5194 2226
email   jmoncur@netspace.net.au



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<DIV><FONT color=#800000 face=Arial size=2>Jenny,</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>This becomes a semantics 
exercise.&nbsp; </FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Where I live, at this time of year, 
the drive to the hospital is typically much more violent than the hike out of 
the ditch.&nbsp; Frost heaves in Maine can take an unrestrained driver right out 
of his seat (an under-appreciated cause of MVC), so I'm not keen on 
de-immobilizing a patient with a suspected neck fracture until he's in a nice, 
stationary building.</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Extrication, transport, whatever: 
splint suspected fractures until external forces are under control.&nbsp; Fair 
enough?</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>You raise Arabians?&nbsp; Used to 
have a couple when I was a kid.&nbsp; Extraordinary animals.</FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2>Pret<BR><BR><FONT 
color=#000000>-----Original Message-----<BR>From: Jenny Moncur [</FONT></FONT><A 
href="mailto:jmoncur@netspace.net.au"><FONT color=#000000 face=Arial 
size=2>mailto:jmoncur@netspace.net.au</FONT></A><FONT color=#800000 face=Arial 
size=2><FONT color=#000000>]<BR>Sent: Monday, April 14, 2003 10:55 PM<BR>To: 
trauma-list@trauma.org<BR>Subject: Re: Spine 
Immobilization<BR><BR><BR><BR>&gt;*********** REPLY SEPARATOR 
***********<BR>&gt;<BR>&gt;On 14/04/03 at 7:20 AM Bjorn, Pret 
wrote:<BR>&gt;<BR><BR>&nbsp;A long board is NOT A TREATMENT; it is a TRANSPORT 
DEVICE.<BR><BR>.................................<BR><BR>Pret, I believe that a 
long board is actually an EXTRICATION device, not a transport device.<BR><BR>A 
conscious, compliant patient will be be more comfortable, and hence more 
inclined to lie still on a stretcher in the back of a moving vehicle, than on a 
rigid board where they will frequently slide up and down in response to 
acceleration and deceleration of the car (despite various straps and head 
rolls). Speaking from experience (working around horses will give you this), 
even a short trip on a spine board is awfully uncomfortable, and makes the sore 
bits sorer and the patient more inclined to wriggle.<BR><BR>With regard to the 
'sand bag' issue, as a paramedic I use two towels rolled into a cylinder and 
wrapped in tape.. Theses rolls are then placed one each side of the patients 
head and taped to the stretcher. This then encloses the head in a soft support, 
but the patient is not himself strapped down to the stretcher, avoiding the risk 
of a fixed head and a non fixed body (pendulum effect).<BR><BR>Of course, this 
all applies to the fully conscious, alert and cooperative 
patient.<BR><BR>Cheers<BR>Jenny Moncur<BR>IC 
Paramedic<BR>Victoria<BR>Australia<BR><BR><BR><BR>Jenny Moncur<BR>'Mullungdung 
Arabians'<BR>Willung South, Victoria<BR><BR>Situated near the 
beautiful<BR>Mullungdung State Forest in<BR>Gippsland<BR><BR></FONT>ph/fax&nbsp; 
(03)&nbsp; 5194 2226<BR>email&nbsp;&nbsp; 
jmoncur@netspace.net.au<BR><BR><BR><BR>--<BR>trauma-list : TRAUMA.ORG<BR>To 
change your settings or unsubscribe visit:<BR></FONT><A 
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face=Arial 
size=2>http://www.trauma.org/traumalist.html</FONT></A><BR></DIV></BODY></HTML>

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