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Wed, 16 Apr 2003 09:23:37 +1000

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Hello Pret,
I certainly agree with you when talking about the sort of treacherous road=
 conditions you describe. No argument  

Yep, Arabians are my passion - they keep me sane (my husband thinks I'm=
 insane, but don't they all)

Cheers
jenny
*********** REPLY SEPARATOR ***********

On 15/04/03 at 6:53 AM Bjorn, Pret wrote:
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]
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
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>Hello Pret,</DIV>
<DIV>I certainly agree with you when talking about the sort of treacherous road 
conditions you describe. No argument&nbsp; </DIV>
<DIV>&nbsp;</DIV>
<DIV>Yep, Arabians are my passion - they keep me sane (my husband thinks I'm 
insane, but don't they all)</DIV>
<DIV>&nbsp;</DIV>
<DIV>Cheers</DIV>
<DIV>jenny<BR><FONT face=Arial size=2>*********** REPLY SEPARATOR 
***********<BR><BR>On 15/04/03 at 6:53 AM Bjorn, Pret wrote:</FONT></DIV>
<BLOCKQUOTE 
style="BORDER-LEFT: #000000 2px solid; MARGIN-LEFT: 5px; PADDING-LEFT: 5px">
  <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></FONT></DIV></BLOCKQUOTE></BODY></HTML>

<PRE>
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
</PRE>

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