What do your protocols say about spinal immobilization for penetrating trauma?

[craig]

A case in point : high speed motor vehicle crash. When I arrived on scene there were folks trying to do CPR on the driver. I made everyone stop and look at the scene. The drivers brain matter was all over the house into which he had crash landed.

edit to add

Injuries incompatible with life is a term that needs to be thought about..

and where is this an intra cardiac penetration? if there was brain matter "all ove the house" I would not have started CPR either........

However, if the patient was being treated and had a penetrating traume and went in to an arrest situation, my role would not stop, as there could be a chance i could reverse it................why bother with intracardiac adrenaline if the penetration of the needle to the pericarium punctures the heart (as it is suppose to do) and the pateint is in an arrest..........goes against what you are saying.

incompatable to life injuries, no argument there on whether to start.......

[Doczilla]

To the original post, immobilization of patients with penetrating trauma doubles their mortality rate. Even with penetrating injury of the spinal cord itself or supporting structures, the damage is done. Don't immobilize them.

To the question about penetrating trauma arrest, transport is not indicated unless the patient can be in the trauma bay within 5 minutes of the arrest. This only applies to penetrating trauma of the trunk, not the head. All we can do is a thoracotomy in the trauma bay, and survival rates are abysmal. Shot in the head + no pulse = dead.

'Zilla

(null)

[Arctickat]

To the original post, immobilization of patients with penetrating trauma doubles their mortality rate.

Hey Doc, got any data to back that up? I'd Google, but I'm too lazy.

Edited July 14, 2012 by Arctickat

[Doczilla]

Yes, look at my post on the spinal immobilization thread in the patient care forum.

(null)

[Bieber]

No immobilization unless suspected spinal injury.

[BEorP]

To the original post, immobilization of patients with penetrating trauma doubles their mortality rate. Even with penetrating injury of the spinal cord itself or supporting structures, the damage is done. Don't immobilize them.

Shhhhh! Now no one is going to admit that their service still requires it!

[Bullets]

Penetrating trauma to Head, Neck, Torso

"SMR should be CONSIDERED when the patient displays such fidnings as numbness, tingling, and loss of motor or sensory function or actual LOC. However, if the patient with penetrating injury have no neurological complaints, seconday mechanism of injury, or findings, the spine does not need to be immobilized (although the backboard may still be used for lifting and transport purposes)"

Basically taken verbatim from the PHTLS book, natch