C-collar without a backboard?

[grumpymedic4]

well here is my 2 cents worth on this subject. i have had elderly patients that have osteoporosis along with curviture of the spine. c/o neck and back pain, but due to there condition they cannot tollerate being placed on a LSB. thereforwe they are collared and placed in position of comfort i.e. rigth or left side on a pillow straped to the cot and transported, i have also had patients that were in m.v.c. that c/o neck and back pain that agree to treatment and you get them collared. and when it comes time to put them on the L.S.B. they say your not putting me on that thing i cant stand to lay flat or i am closterfobic. i have had it done to me, so now here is the delima you have a patient with c-collar on thats refusing to go on a L.S.B. who is authorized to remove the collar ? i know who is not . (YOU). once an appliance is placed on a patient . it is there untill a doc. removes it or the patient does it themselves . as far as not having enough boards.it can happen . especially in rural areas such where i am from . your truck can only carry so much.i worked a m.v.c one day with 2 children and there mother the oldest child was placed on the only pedi-pac, the mother was placed on l.s.b. with the youngest child of about 1-2 yrs of age was throwing a fit everytime we got near her, she was not about to let us put a c-collar on her.so for the risk of more possible injury to her she was secured to her mother with straps across child and mother. the child was very content being on her mothers chest and belly face up. yes there are medics and e.m.t"s that are burnt out and lazy. for them it is time to get out of the business. to call everyone stupid and lazy i take great offence to. it's called document, document, document, and refusal form . thank you for your time!

[Richard B the EMT]

As I see it...

If using a C-Collar, spinal long board will be used.

I'm in an area where backup is usually not too far away. Run out of long boards? Request another unit to either drop one off, or assume patient care as THEY put the patient onto their long-board.

If and when a KED or the Iron Duck Extrication Appliance (IDEA) is used (FDNY EMS uses both), the patient so immobilized will also be on a long-board, and a C-Collar on under the KED or IDEA, under my mantra of LOCAL PROTOCOLS.

The patient who really needs immobilization but refuses it? Document DOCUMENT DOCUMENTthe Refused Medical Assistance, but they might still sue you and/or your agency.

If the patient is out of the vehicle (presuming a car accident), you might want to do a "standing take-down", where you hold a standing patient in immobilization, put a c-collar on them, and place a spinal long board behind them, and lower both patient and board, as a single unit, to the laying down position, then secure the patient to the board.

Yes, that last takes practice to do well, but I feel it is easy to learn.

"Spider Straps?" I presume that these are the straps that come over the patient's shoulders to join up with the uppermost of the torso straps. Rumor has it the FDNY EMS is going to go to these type patient safety straps (not calling them patient restraints, might have a battle of the phrases I really do NOT wish to get into).

[bandaidpatrol]

clearly you do not work in emergency medicine. a c-collar is used with suspected spinal injury. if a spinal injury is suspected, why would anyopne not use proper spinal immobilization???? put down the vague doctors journals and get some real life experience.

All the collar does is keep the Cervical spine from extending. If the provider uses the correct size. Do you measure every patient to make sure the collar you are using is correct for them. Because if you don't do that, it doesn't matter anyway. And it's not immobilization of the Torso & Lumbar spine to worry about, it's the splinting of a pelvis and sacral spine. If the pelvis is allowed to move freely, the rest is useless, as this results in twisting of the spine. As long as the head is kept in a neutral position, and prevented from moving side to side, it's all good. A collar does not prevent the head from moving. I'm not saying don't use a collar, I'm saying "Think".

[Scarlett Butterfly7]

Will if a guy's got a gun, is bleeding all over the place because he was just in a gunfight I would let the police deal with that guy first for my own safety, shoot forget about backboard for a second

[Scarlett Butterfly7]

and for the person against backboard because they can cause more damage, do they have or use inflatable backboards? because they have a picture of one in my emergency medical care book ad that would solve the space problem

[bandaidpatrol]

Inflatable?

How does that keep them from moving?

All I can picture is one of those flat rafts for a swimming pool.

[Ridryder 911]

Like to see the inflatable one ... never ever heard oe seen one of those either?

Be safe,

R/R 911

[Docdor]

Inflatable?

How does that keep them from moving?

All I can picture is one of those flat rafts for a swimming pool.

As a matter of fact, this device is named Back Raft (Boundtree) and it is very much like a blow-up pool mattress. The idea is to pad the board but you are correct that it does not help much with limiting motion, single use, costly and it just adds to the complexity of pt. packaging...a swing and a miss. Again, try the vacuum splint method I described above.

[Docdor]

Has anyone seen or heard of a board with built in pads?...I believe it's called the Innova board, or something like that. I'd like to hear from anyone who has one or has seen one in use.

[Dustdevil]

Has anyone seen or heard of a board with built in pads?...I believe it's called the Innova board, or something like that. I'd like to hear from anyone who has one or has seen one in use.

You are possibly talking about this:

http://www.innovativemed.net/

There was a discussion about this device several months back that can be found at http://www.emtcity.com/phpBB2/viewtopic.ph...p;highlight=mat

At that time, it was unanimously concluded that it is worthless because there is no way to get the patient on the device without overmanipulating them.