Back boarding question

[Chief1C]

Has anyone used the X-Collar?

[DwayneEMTP]

Zippy, I've never had any issues with pt slipping around on a quartered blanket.

A properly restrained pt shouldn't have much room to slip around, and if the situation occurs to cause them to slip I can't see where the blanket would cause them to slip more than they would when wearing clothes, a gown or being sweaty and naked.

The main benefit, other than feeling like a better person for making them more comfortable, is that it eliminates most of the voluntary movement in the majority of pts. They don't fight so hard if they aren't so uncomfortable. And more comfortable means better history, more compliance to interventions, more cooperation. At least that's been my experience.

Without a direct order from a physician, or some other unforseen, unavoidable complication, I will never again choose to board a pt without the blanket.

Dwayne

[PCP]

Zippy, I've never had any issues with pt slipping around on a quartered blanket.

I agree with Dwayne on this one. I feel if the pt. is on a blanket which they should be for pt comfort and properly restrained there should not be much room to slip around.

The main benefit, other than feeling like a better person for making them more comfortable, is that it eliminates most of the voluntary movement in the majority of pts. They don't fight so hard if they aren't so uncomfortable. And more comfortable means better history, more compliance to interventions, more cooperation. At least that's been my experience.

Without a direct order from a physician, or some other unforseen, unavoidable complication, I will never again choose to board a pt without the blanket.

Dwayne

OOPS!! Sorry guys, still trying to figure out how to quote something from a another post.

[DwayneEMTP]

OOPS!! Sorry guys, still trying to figure out how to quote something from a another post.

+1 from me for making the effort!

Dwayne

[Aussieaid]

Since we have an abundance of anecdotal stories I will share a couple of calls I was actually on.

The first one was an interfacility transport for a patient who had tipped his quad motorbike over onto it's side the previous evening. Being a tough farmer he walked home and went to bed. The ambulance was called in the morning when he had trouble getting out of bed but no other obvious neuro deficits. At the local hospital a c-spine xray was done which showed a high cervical fracture at which point a c-collar was placed and we were called to transport him to a trauma center. When we arrived he had no other deficits except mild weakness and mild neck pain. We fully immobilized the patient for transport on a blanket padded backboard with no problems en route. I agree with the people who pad their backboards and do it everytime without any problems with the patients sliding. This pt ended up having an unstable C2 fracture as well as lumbar and sternal fractures. This guy was very LUCKY!

Number 2 was a scene call in which the vehicle did a couple of 360's and hit an embankment. Minor damage to the vehicle and only one person with an injury. This pt had no outward signs of trauma and was moving everything until a friend tried to help them out of the vehicle at which point they became a complete quadriplegic from such a severe injury to their neck that there was nothing the Drs can do to treat it. (Multiple, complex cervical fractures with a completely transected cord)

Number 3 helps perpetuate the c-collar/immobilization controversy. Another scene call in which the patient almost decapitated themselves with their motorcycle helmet strap. Luckily they missed major vessels but it looked like their throat had been cut. Because of trauma to the neck at the level of the hyoid bone a c-collar was not placed and the pt was immobilized with BB and a CID only and padding over the wound (PTA). We intubated the patient for a number of reasons and kept him paralyzed post intubation so he was not at risk of moving. Afterwards the neurosurgeon told us that with this patient's particular type of unstable high cervical fracture that if a c-collar had been applied the patient would probably have ended up paralyzed. As it was he had no neuro deficits with the injury. Another super lucky guy! Still this was one of those rare injuries where a c-collar can actually hurt rather than help.

On another note that X-collar looks like it would make intubation a little tricky!

[Carl Ashman]

Hi all!

A group of colleagues here in Holland have just finished a study into pre-hospital immobilization. It took 6 years and included 3000 patients. The conclusion: there is not one single shred of credible evidence to support spinal immoblization with a c-collar and backboard. In children it is even detrimental due to their size, anatomy and relatively higher risk of aspiration. I believe it's being translated into english, as soon as I have a link,I'll post it here.

Carl.