Spinal precautions

[medichopeful]

I have a quick question,

Is there any harm in putting a person with suspected spine injury onto a backboard before applying a cervical collar? This is for a trauma assessment, so the steps would go something like this (this only includes relevant parts):

1) sticky test

2) roll patient onto side

3) do rapid assessment of neck, back (during the sticky test, so you can get it done and out of the way)

4) place patient on backboard when rolling to supine position(not secured)

5) apply cervical collar

6) secure patient to backboard

We have not gone over backboarding yet, but I would like to know.

Thanks!

Eric

[Lone Star]

If you're treating someone of a suspected spinal injury, you're going to have your partner holding c-spine. When you go to log roll the patient to their side to palpate the spine and prepare them for boarding, the C-collar will actually help your partner keep the neck in a neutral inline position.

You'll see this thought process outlined as you cover the backboarding process.

[Dustdevil]

I dunno what a "sticky test" is. Must be a Mass thing.

The question is complicated. If the patient had solid indications for spinal immobilisation, then yes, there is risk of harm from doing it poorly. No doubt about that. However, if there were no indications for immobilisation -- as is the case in the vast majority of patients that EMTs immobilise -- then no, there is no harm.

As always, it is not the "skill" that is so important as is the education and judgement necessary to intelligently implement it.

[fenwayfrankee]

I have been doing EMS for the better part of a decade in Mass and have never heard of the sticky test...

[mobey]

I don't think you realize the magnitude of the question you are asking.

There is no science behind C-Collars, so it is nearly impossible to answer your question. As a health care provider it would legally foolish of us to tell you to veer out of the "standard of practice".

[scubanurse]

I dunno what a "sticky test" is. Must be a Mass thing.

The question is complicated. If the patient had solid indications for spinal immobilisation, then yes, there is risk of harm from doing it poorly. No doubt about that. However, if there were no indications for immobilisation -- as is the case in the vast majority of patients that EMTs immobilise -- then no, there is no harm.

As always, it is not the "skill" that is so important as is the education and judgement necessary to intelligently implement it.

I'm scared about the "sticky test" wtf...

If you do things backwards you are putting your patient at risk. EMS Standards state to place the collar THEN move onto a backboard....

Follow protocol and SOP's... and wth is a sticky test?!?

[Dustdevil]

... and wth is a sticky test?!?

Okay, I'm feeling better about my reply now. I thought for sure everyone was going to tell me I was hopelessly out of touch for not knowing what a "sticky test" was.

Sounds disgusting, whatever it is!

[medichopeful]

Alright you pervs

A "sticky test" is basically a quick test to detect the presence of any leaking bodily fluids. It consists of putting the hands on all visible parts of the body (the parts on the ground) and checking for the presence of blood or any other, sticky bodily substances. It has another name, but I have always referred to it as a sticky test.

Now get your minds out of the gutter!

Eric

[mobey]

Alright you pervs

A "sticky test" is basically a quick test to detect the presence of any leaking bodily fluids. It consists of putting the hands on all visible parts of the body (the parts on the ground) and checking for the presence of blood or any other, sticky bodily substances. It has another name, but I have always referred to it as a sticky test.

Now get your minds out of the gutter!

Eric

Ahhh.... the wet check!

I never really understood it myself.

So go head to toe touching the patient looking for blood on my hands which are covered by a micro layer of nitrile.

Then Go head to toe touching the patient looking for fractures and painful sensation on palpation.

Why again did I have to stick my hands on thier blood in the first place??

Side note: Doesn't it seem stupid to stick your hands under a patient who is laying on the sidewalk without visualizing first? Sounds like someone is in a hurry to destroy the back of thier gloves, and get stuck with the dirty needle the guy is laying on............

Just sayin

[medichopeful]

Ahhh.... the wet check!

I never really understood it myself.

So go head to toe touching the patient looking for blood on my hands which are covered by a micro layer of nitrile.

Then Go head to toe touching the patient looking for fractures and painful sensation on palpation.

Why again did I have to stick my hands on thier blood in the first place??

Side note: Doesn't it seem stupid to stick your hands under a patient who is laying on the sidewalk without visualizing first? Sounds like someone is in a hurry to destroy the back of thier gloves, and get stuck with the dirty needle the guy is laying on............

Just sayin

I don't know about you, but I would LOVE to have my hands get covered in blood for the rest of the call.

Just saying