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Thu, 6 Feb 2003 10:23:49 +1100

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There are several journal articles (one in JEMS about two years ago I =
think) that discuss the topic of endotracheal tube movement during =
flexion / extension / rotation of the patient's head. The one I recall =
is by Paul Matera & concerned a study undertaken by him using cadaveric =
models to quantify tube movement. This was then followed up in JEMS by =
Gaston County EMS that had introduced a protocol of cervical =
immobilisation in all tubed patients (traumatic & non-traumatic).=20

There are a few other studies out there looking at endotracheal tube =
movement that make for interesting reading.

Peter Grove
Clinical Nurse Specialist
Department of Trauma & Retrieval Services
(Incorporating the Sydney Aeromedical Retrieval Service)
St. George Hospital
Gray Street
Kogarah. NSW. 2217

-----Original Message-----
From: Nick Nudell [mailto:emsnick@northerntel.net]
Sent: Thursday, 6 February 2003 9:35
To: trauma-list@trauma.org
Subject: Re: non-traumatic cervical immobilisation?

John

Why do you feel that placing a c-collar on a medical cardiac arrest =
patient
will do more harm then good? Aren't they dead already? If the c-collar =
is
good for live people, how can it be bad for dead people?

Have you ever 'lost' a tube because of moving a patient from their =
cramped
bathroom floor onto the cot in the next room? or tried to carry a =
backboard
down stairs and around a corner while still trying to maintain the
placement? or how about the ambulance driver making an evasive steering
maneuver while your ventilating causing dislodging of the ET?

Regards
Nick

Nick Nudell, NREMT-P, CCEMT-P
Montana
nudell@prehospital-perspective.com

"Perception is reality" - Wise Old Paramedic

> How would you feel if I followed the suggestion below that I perform
> cervical immobilisation whether traumatic or non-traumatic?
> Do you still clear the spine if a crew brings in a tubed patient from =
a
> non-traumatic cardiac arrest that they have collared?
>
>
> It is seldom (probably never) necessary to put a neck collar on a
"medical"
> cardiac arrest case.
>
> Probably will do far more harm than good.
>
> John
>
>
> Dr John L Holmes
> Director Emergency Medicine
> Mater Health Services
> Brisbane,  Australia
>

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non-traumatic cervical immobilisation?