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C-Spine collars.....best for Prehospital use

Mike Smertka medic0947969 at yahoo.com
Sun Aug 17 03:30:29 BST 2008


Pret,
 
I can see they are good for getting people off the ground, but I think the usefulness ends there. (I know some people who swear by scoop stretchers for the same reason)The current US EMS practice of focing people onto them, and all the straping and taping that follows I don't think helps and have seen studies that show it actually harms. When I was first instructed on the use of the spineboards, I was taught to pad all the voids and the actual board. I cannot remember the last time I saw that done by anyone. I am sure you have also seen people lay on them for hours as well. But the same person can lay in a hospital bed with just a c collar and be considered in precautions.(who is not physically restrained from protecting their own airway) just my thoughts.
 
Mike 

--- On Sat, 8/16/08, Pret Bjorn <p.bjorn at netzero.net> wrote:

From: Pret Bjorn <p.bjorn at netzero.net>
Subject: RE: C-Spine collars.....best for Prehospital use
To: "'Trauma & Critical Care mailing list'" <trauma-list at trauma.org>
Date: Saturday, August 16, 2008, 9:25 PM

For all of the same reasons, plastic backboards are the PERFECT tool for the
job: cheap, simple, quick to apply and remove.  Plus they have the benefit
of handles to get the patient off the ground and onto the truck.

Our problem with backboards is that we leave them on well past the phase
wherein they're indicated (transport).

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Mike Smertka
Sent: Friday, August 15, 2008 11:15 PM
To: Trauma & Critical Care mailing list
Subject: RE: C-Spine collars.....best for Prehospital use

Well said,
 
any thoughts on how to ditch the plastic backboards also? Be a shame to
still be looking at them 20 years from now like MAST trousers
 
Mike

--- On Fri, 8/15/08, Bjorn, Pret <pbjorn at emh.org> wrote:

From: Bjorn, Pret <pbjorn at emh.org>
Subject: RE: C-Spine collars.....best for Prehospital use
To: "Trauma & Critical Care mailing list"
<trauma-list at trauma.org>
Date: Friday, August 15, 2008, 1:40 PM

Gregory,

With all respect, you're thinking too much.  It stems from a common
phenomenon I've come to refer to as "Spinal Fixation."  The first
step
in recovery is admitting you have a problem.

Prehospital spinal management requires a SPLINT: simple, temporary,
cheap.  There is no evidence that an expensive  plastic Tinker Toy
yields any better outcomes than a carefully wadded 75-cent daily
newspaper.  

Don't be offended; it's just the nature of the task at hand.  Your
objective is to quickly immobilize and transport the patient.  That's
WAY different than that of the ED or inpatient unit, to whom you owe
nothing if up until then you've kept the spine still.  (In our hospital,
no patient with spinal precautions leaves the ED without a Miami-J(R)
collar.  That's sixty-something bucks, non-reusable, and surprisingly
easy to do wrong.  You don't want nor need to rise to that bar.)

Go with something your squad can easily afford, intuitively learn, and
quickly apply.  Don't sacrifice ANY of these objectives to impress or
conform, unless you can reduce preventable cord injury in the
prehospital phase -- which none of the commercial gizmos can claim.

Pret Bjorn, RN
Bangor, ME USA



-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of
msmaltini345 at aol.com
Sent: Thursday, August 14, 2008 9:15 AM
To: trauma-list at trauma.org
Subject: Re: C-Spine collars.....best for Prehospital use





I am currently ordering in stock for our station and would like to get
some input as to you recommendations/thoughts on the following:
1) Using the adjustable collars vs rigid non-adjustable
2) On arrival at ED which seems to do the job best.
3) What would you recommend for pre-hospital use?
4) What is used within your service/area and do you feel they are
effective?


WE USE PERFITACE FROM AMBU. 1 SIZE..MUCH EASIER THAN CARRYING MULTIPLE 
SIZES



-----Original Message-----
From: Hillen Gregory <Gregory.Hillen at oxamb.nhs.uk>
To: trauma-list at trauma.org
Sent: Wed, 13 Aug 2008 11:09 pm
Subject: RE: C-Spine collars.....best for Prehospital use



Dear All,

I am currently ordering in stock for our station and would like to get
some input as to you recommendations/thoughts on the following:
1) Using the adjustable collars vs rigid non-adjustable.
2) On arrival at ED which seems to do the job best.
3) What would you recommend for pre-hospital use?
4) What is used within your service/area and do you feel they are
effective?

I do realise that is up to the training, individual preference, space on
vehicles etc etc but your thoughts would be appreciated.

Regards.
Gregory Hillen
FF/USART/SR Para

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