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Posted

Hey all.

I was watching the new after a bus accident a bit ago and noticed a male teen on the stretcher, semi-fowler, with a c-collar on.

I was never taught a scenario for use of a c-collar without a backboard. Doesn't even seem an honest attempt at CYA.

(And dang it Dust, Medik7, ace, ak .... though I know this smacks of having been asked a million times before, I did do a search on c-collar

but didn't find it addressed :lol: )

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Posted

The reason you were not taught this technique, it is because it does not exist. Since a c-collar doesn't actually offer much protection when dealing with a patient with a suspected c-spine injury it is not effective without a long board, proper straping, and c=spine imobilization with head blocks. Only applying a c-collar is lazy and half-a$$ing it. If you apply a collar the long-board should be following right behind.

Posted

I used to put Philly collars on patients who refused to be boarded or collared with a modern collar. It was soft, yet provided the support necessary. But, they signed off, so it freed me of any claims or legal action. It was just my way of CYA.

Perhaps the kid had no pain, etc; and didn't want to be strapped down. You can't force them to be boarded..

Of course, he could have been 18 yrs of age, and signed a refusal for the board, but agreed to the collar. Never know..

Posted
Only applying a c-collar is lazy and half-a$$ing it. If you apply a collar the long-board should be following right behind.

Preciesly =)

Perhaps the kid had no pain, etc; and didn't want to be strapped down. You can't force them to be boarded..

If he had no pain, I can understand this one. However, if they have a significant mechanism of injury and they say "My necy/back/head hurts." they are going on the board. It's not thier choice any more.

Posted

Preciesly =)

If he had no pain, I can understand this one. However, if they have a significant mechanism of injury and they say "My necy/back/head hurts." they are going on the board. It's not thier choice any more.

Really? It's not their choice any more? So you're going to tell an alert and oriented patient what WILL be done against their wishes? That sounds like a less than smart decision if you ask me. An alert and oriented patient has the legal right to refuse any and all medical care...even if it will be life saving. Unfortunatly, unless they are a danger to themselves or someone else, you cannot force an unwanted treatment on this patient (provided they are 18 years of age or older). The mechanism may be there, the injury may be there. But if they don't want the treatment, they are allowed to sign off on it. Documentation is the key here and obtaining the proper signatures.

Hopefully you meant this as if the patient said that we as providers could do whatever is needed and it was the decision of the crew to not immobilize to an LSB. If it's the patient's decision, I wouldn't violate their rights.

Shane

NREMT-P

Posted

hmm not really. They have few choices with me... either they can receive treatment as deemed necessary (i.e. LSB) and if to prevent a fuss, they have to sign a waiver recognizing they are releasing us from responsibility and going against medical advice. Some insurance companies will refuse to pay for AMA etc.. and also decrease their chance litigation as well. Funny, how most will change their mind, when informed when informed.

Be safe,

R/R 911

Posted

That's BS that someone didn't have enough backboards. You know what you do if you don't have a backboard? You put a C-collar on and hold manual stabilization alllll the way to the hospital. It's an accepted, though not common, practice.

Posted

What about the short boards? my squad has short boards on the truck. why not use one of them if you're worried about c-spine?

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