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Spine Immobilization

Eitan Melamed trauma-list@trauma.org
Thu, 17 Apr 2003 00:53:33 -0700 (PDT) 

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The variety of techniques and lack of evidence make it difficult to recommend a single method. Combination of cervical collar( rigid) with lateral support, on a rigid backboard is still considered safe and effective.I think that in penetrating trauma prehospital spine immobilization is a non-issue. Do you agree?regardsEitan  

Andy Brainard <abrain@rt66.com> wrote:
> -----Original Message-----
On Behalf Of Nick Nudell
> Sent: Wednesday, April 16, 2003 7:28 PM
> 
> >The soft immobilization is there to remind the patient to hold still.
> 
> Yes, but the question remains... if it is important for the patient to
> hold
> still (because of possible injury) then what are you going to do when
> something beyond the patients control happens?
> 
> If it really is not a risk, then what is the reason for soft
> immobilization?
> If it is a risk, then why perform soft immobilization, which is really a
> misnomer as there is no immobilization taking place.
> 
> Regards
> Nick
> 
[AB] 

Nick, 

Reminding the patient (and providers) by placing soft restraints has a much
better risk-benefit profile than a hard backboard.

Once strapped to a hard spine board, a cooperative stable patient is much
less likely to suffer an iatrogenic spinal cord injury than they are to
develop iatrogenic bed sores, iatrogenic discomfort, and iatrogenic
claustrophobia.

A cooperative stable patient, urged remain still, gently placed on a soft
gurney, gently strapped in, and reminded again to hold still with soft rolls
is extremely unlikely to suffer an iatrogenic spinal cord injury and not at
all likely to develop iatrogenic bed sores, iatrogenic discomfort, and
iatrogenic claustrophobia.

That's how I would like to be treated.
[AB] 


Andy Brainard
mailto:abrain@rt66.com
Cell: (505)220-7930
Home:(505)771-0583



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<DIV>The variety of techniques and lack of evidence make it difficult to recommend a single method. Combination of cervical collar( rigid) with lateral support, on a rigid backboard is still considered safe and effective.</DIV>
<DIV>I think that in penetrating trauma prehospital spine immobilization is a non-issue. Do you agree?</DIV>
<DIV>regards</DIV>
<DIV>Eitan&nbsp; <BR><BR><B><I>Andy Brainard &lt;abrain@rt66.com&gt;</I></B> wrote:</DIV>
<BLOCKQUOTE style="BORDER-LEFT: #1010ff 2px solid; MARGIN-LEFT: 5px; PADDING-LEFT: 5px"><BR>&gt; -----Original Message-----<BR>On Behalf Of Nick Nudell<BR>&gt; Sent: Wednesday, April 16, 2003 7:28 PM<BR>&gt; <BR>&gt; &gt;The soft immobilization is there to remind the patient to hold still.<BR>&gt; <BR>&gt; Yes, but the question remains... if it is important for the patient to<BR>&gt; hold<BR>&gt; still (because of possible injury) then what are you going to do when<BR>&gt; something beyond the patients control happens?<BR>&gt; <BR>&gt; If it really is not a risk, then what is the reason for soft<BR>&gt; immobilization?<BR>&gt; If it is a risk, then why perform soft immobilization, which is really a<BR>&gt; misnomer as there is no immobilization taking place.<BR>&gt; <BR>&gt; Regards<BR>&gt; Nick<BR>&gt; <BR>[AB] <BR><BR>Nick, <BR><BR>Reminding the patient (and providers) by placing soft restraints has a much<BR>better risk-benefit profile than a hard backboard.<BR><BR>Once strapped to a hard spine board, a cooperative stable patient is much<BR>less likely to suffer an iatrogenic spinal cord injury than they are to<BR>develop iatrogenic bed sores, iatrogenic discomfort, and iatrogenic<BR>claustrophobia.<BR><BR>A cooperative stable patient, urged remain still, gently placed on a soft<BR>gurney, gently strapped in, and reminded again to hold still with soft rolls<BR>is extremely unlikely to suffer an iatrogenic spinal cord injury and not at<BR>all likely to develop iatrogenic bed sores, iatrogenic discomfort, and<BR>iatrogenic claustrophobia.<BR><BR>That's how I would like to be treated.<BR>[AB] <BR><BR><BR>Andy Brainard<BR>mailto:abrain@rt66.com<BR>Cell: (505)220-7930<BR>Home:(505)771-0583<BR><BR><BR><BR>--<BR>trauma-list : TRAUMA.ORG<BR>To change your settings or unsubscribe visit:<BR>http://www.trauma.org/traumalist.html</BLOCKQUOTE><p><br><hr size=1>Do you Yahoo!?<br>
<a href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://us.rd.yahoo.com/search/mailsig/*http://search.yahoo.com">The New Yahoo! Search</a> - Faster. Easier. Bingo.
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