Spinal precautions

[Kiwiology]

We threw out longobards a couple years ago and now just use the Ferno scoop stretcher (we have some of the old metal oes lying around still, used one the other week) with a collar.

If you ask me it's probably 70/30 placebo vs benefit

Does that mean I don't do it ... no ... does it mean it should go the way of the MAST pants, no, for now at least until we get some very, very large randomised controlled trials done or get portable x-ray in the ambulance.

Sorry guys but I just laugh my ass off watching things like Trauma: Life in the ER and see a guy come in all boarded up with blocks and tape and whatnot because he fell over on the sidewalk and knocked himself out.

[DwayneEMTP]

We threw out longobards a couple years ago and now just use the Ferno scoop stretcher (we have some of the old metal oes lying around still, used one the other week) with a collar.

If you ask me it's probably 70/30 placebo vs benefit

Does that mean I don't do it ... no ... does it mean it should go the way of the MAST pants, no, for now at least until we get some very, very large randomised controlled trials done or get portable x-ray in the ambulance.

Sorry guys but I just laugh my ass off watching things like Trauma: Life in the ER and see a guy come in all boarded up with blocks and tape and whatnot because he fell over on the sidewalk and knocked himself out.

Yeah man, you make a great point. I love the scoop. Way more comfortable for people, they stay more easily in the center, less movement on our freaky country roads...much better option I think, though again, I can't prove it. All geriatrics, if I absolutely can't clear them, go on the scoop.

And I agree completely with the rest of your post as well.

Dwayne

[P_Instructor]

Yeah man, you make a great point. I love the scoop. Way more comfortable for people, they stay more easily in the center, less movement on our freaky country roads...

I think I'm going to have to dust mine off and get back to using it again.....you and Kiwi are right..

[scubanurse]

A lot of the new scoop stretchers, I've been told, are meant to also be used as a LSB... am I wrong?

[P_Instructor]

A lot of the new scoop stretchers, I've been told, are meant to also be used as a LSB... am I wrong?

It does depend on which kind you obtain. Basically what sort of gap do you have, and how can you secured your patient best to them. Most of the new ones are good, but that is from someone who is used to the old lightening rods.

[Dustdevil]

A lot of the new scoop stretchers, I've been told, are meant to also be used as a LSB... am I wrong?

I have always used them as such whenever possible. Not very handy when sliding someone out of a car though.

[Canadian Caesar]

First off, while not actually dealing with the subject at hand per se, the following study did come to the surprising conclusion that Log-Rolling Pt's produced far more potentially injurious C-spine motion then the "Lift-and-Slide" technique. Anybody else surprised?

The Spine Journal

Volume 4, Issue 6, November-December 2004, Pages 619-62

C-Spine.pdf

Sorry guys but I just laugh my ass off watching things like Trauma: Life in the ER and see a guy come in all boarded up with blocks and tape and whatnot because he fell over on the sidewalk and knocked himself out.

In regards to your post Kiwi, this is from an older post of mine. It does not take much force to cause a c-spine fracture. Dust was right on the money when he said: "the unfortunate fact is that there is no recognised, objective criteria available in an unconscious patient with which to rule out spinal injury. "

<b>According to the following Medical journal article (The European Spine Journal) Eur Spine J (1995) 4:126-132:

Kinematics of cervical spine injury: A functional radiological hypothesis

L. Penning

Departments of Diagnostic Radiology and Neurosurgery, University Hospital of Groningen AZG, Groningen, The Netherlands</b>

It only requires 8kg of Axial Traction on the cervical spine to cause a "Hangman's Fracture."

To put that force into terms you may have felt yourself, the relatively mild maximum 15lbs of force you use in the application of a traction splint to a femur fracture is enough to cause this type of fracture.

[JPINFV]

First off, while not actually dealing with the subject at hand per se, the following study did come to the surprising conclusion that Log-Rolling Pt's produced far more potentially injurious C-spine motion then the "Lift-and-Slide" technique. Anybody else surprised?

The Spine Journal

Volume 4, Issue 6, November-December 2004, Pages 619-62

C-Spine.pdf

In regards to your post Kiwi, this is from an older post of mine. It does not take much force to cause a c-spine fracture. Dust was right on the money when he said: "the unfortunate fact is that there is no recognised, objective criteria available in an unconscious patient with which to rule out spinal injury. "

I don't think that axial traction can describe the vast majority of trauma injuries that result in patients being back boarded. Similarly, I doubt that there are very many asymptomatic unstable fractures caused by axial traction.

[Canadian Caesar]

I don't think that axial traction can describe the vast majority of trauma injuries that result in patients being back boarded. Similarly, I doubt that there are very many asymptomatic unstable fractures caused by axial traction.

I intended for my post to indicate that it requires far less force to cause a c-spine fracture than many people believe. I don't know how anybody can feel comfortable ruling out c-spine on an unconscious head trauma pt.

[DwayneEMTP]

I intended for my post to indicate that it requires far less force to cause a c-spine fracture than many people believe. I don't know how anybody can feel comfortable ruling out c-spine on an unconscious head trauma pt.

Hmmm...I didn't reread the thread, but I'm not sure where it was said that anyone would do this.

It's my belief that most that do clear c-spine in the field do so via the Nexus criterium. Certainly an unresponsive head trauma won't meet that standard.

Dwayne