List Archives

Fri Aug 17 12:05:11 BST 2007

Yes we have used a selective spinal protocol here for at least a year, it's
not a prehospital clearance but certainly allows for many fewer patients to
require an unneeded LBB.

 Jim< 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Mike Smertka
Sent: Thursday, August 16, 2007 10:19 PM
To: Trauma &amp, Critical Care mailing list
Subject: getting rid of the backboard

I have tried many different arguements I have yet to be able to actually
convince EMS providers or medical directors to drop mandatory spinal
immoboilization. Has anyone else been able to? If you have, how did you go
about it?

  Mike

Bob Waddell II <bobwaddell at bresnan.net> wrote:
  The greater question is, "what is the ethical considerations for spinal
immobilization?" More and more data showing that we in the US over
immobilize without medial benefit to the patient. One only has to look
at the X-game "Boarder" with the WELL documented vertical fall from 45
ft without any spinal injury. He did have other injuries that were
treated upon admission to the hospital.

All or nothing? A protocol with historical roots that refuses to
acknowledge evidence based advancements? There are times I truly
believe (tongue in cheek) that in the days of Sheriff Matt Dillon they
used coffin lids as a way to carry the shot bad guys up stairs to Doc's
office. If they lived they came off the coffin lid and went to jail.
If they died they were carried down to the stable, the died guy and lid
were quick flipped over and nailed down to the coffin. At some point in
time a really smart medical person saw all this and decided that the
coffin lids was actual a spinal protective device and history tells the
rest!

Where is the care of the patient in the protocol?

Take care,
Bob

bobwaddell at bresnan.net 

307 920 2020
-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Ben Reynolds
Sent: Thursday, August 16, 2007 8:00 PM
To: Trauma &, Critical Care mailing list
Subject: Question for the prehospital experts

When, if ever is it acceptable for a patient involved
in an MVA to be made to walk from the car into the
back of the ambulance to be boarded and collared? Use
the following example from which to springboard your
answer:

21 year old restrained female head on collision with a
stationary vehicle. Airbags deploy. Patient has a
large cut on her head but is out and walking around. 

Ben Reynolds, PA-C
Pittsburgh, PA

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getting rid of the backboard