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Home > List Archives

Spine Immobilization

Jenny Moncur trauma-list@trauma.org
Thu, 17 Apr 2003 11:21:57 +1000


Well said, Andy. 
That's all there is to it. A reminder, not an immobilisation.
We also need to acknowledge the ability of the driver to adjust their=
 driving style to a smoother, often slower style knowing that there is a=
 patient on board who would benefit from minimal vehicle movement.=
 (Actually, I reckon this applies to all patients and passengers, myself!)

I have not found too many instances where a careful driver is caught=
 unawares by lorries (trucks in OZ), kangaroos, wind gusts and the like.=
 Maybe I just live and work in a generally placid part of the world? 
Anyway, I take your point, but I stress that I make my decisions based on=
 the clinical presentation, and am not bound by rigid protocols. I am lucky=
 to work ina service that encourages us to use our best judgement, and work=
 'outside the square' if it is in the best interests of the patient.

Cheers
Jenny

IC Paramedic
Victoria,
Australia



*********** REPLY SEPARATOR  ***********

On 16/04/03 at 6:47 PM Andy Brainard wrote:

>The soft immobilization is there to remind the patient to hold still. 
>


>> 
>> Subject: Re: Spine Immobilization
>> 
>> Hi Jenny
>> Thank you for the clarification!
>> 
>> I certainly have had to suction emesis many times from airways of
>> immobilized patients... it usually involves first a lateral recumbent
>> positioning of the board, then adjusting the cot belts and using a=
 pillow
>> to
>> maintain this position, then retrieving the suction equipment and using
>> it.
>> The patient will remain in this position until I feel the airway danger
>is
>> minimized (no more emesis, arrival at hospital, or anti-emetic=
 medication
>> is
>> administered or perhaps intubation).
>> 
>> hmmm, I would like to play devils advocate for a minute, if you don't
>> mind...
>> 
>> If you feel that the patient requires a cervical immobilization device
>and
>> should have lateral supports (towels/blankets, etc)... then you must=
 have
>> a
>> reasonable suspicion of injury, right? otherwise it would be pointless=
 to
>> provide any immobilization...
>> 
>> So, lets say that there will be some emesis, or your driver does make an
>> evasive maneuver (lorries, cars, kangaroos, children, sleepy driver,=
 flat
>> tire, wind gust, whatever)... either of those situations would severely
>if
>> not totally compromise the 'soft' immobilization performed, rendering
>them
>> ineffective, right? So what is the benefit of doing this at all? Is not
>> the
>> patient at greater risk from 'soft' immobilization then from none at=
 all?
>> My
>> reasoning is this... a false sense of security would be reasonable to
>> expect
>> among both the provider and the patient, whom you had a reasonable
>> suspicion
>> of cervical or spinal injury in the first place.
>> 
>> I am very curious to hear your reasoning on this point so that I may
>> understand how you overcome the risk from 'lack' of immobilization to
>> patients with potential injuries...
>> 
>> Kind regards
>> Nick
>> 
>>
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