Most under-"utilised" (canadian term) peice of equ

[CBEMT]

I still want somebody to show me how we're supposed to examine the patient's back after we start scooping everybody to avoid the supposedly horrible logroll.

[scottymedic]

Here in my region, Scoops are used for all immobilisations, we aren't recomended using backboards for the issue of pressure sores. I argued this with my instructor, in the view that they arent on the board long enough to develop pressure areas and the idea of a spine board is to keep the spine in neutral allignment. If they develop pressure areas after we leave, well that the ER's fault not ems (Says the soon to be registered RN lol )

Most under utilised peice of equipment.... hmmmm, I agree on the KED, I love them for immobilisation but each to their own I guess, ummm what else, oh yes the manual BP cuffs too. EMT's hands also, what ever happened to putting a hand on the shoulder to slow resps down or a smile, seems soo many paramedics now adays are so anally retentive they have forgotten how to lol.

Right better go shower and shave, going out for a couple hours on shift tonight. Have fun and be safe

Scotty

[CBEMT]

Here in my region, Scoops are used for all immobilisations, we aren't recomended using backboards for the issue of pressure sores.

Hmm. So we aren't supposed to without O2 from COPD patients because it won't cause a problem in the short time that they're with us, but we're supposed to stop using backboards because they may cause a problem.... in the short time that they're with us?

[scottymedic]

hey I just do the work, I don't work the logic (or lack of) that is management

S

[akroeze]

As professionals we need to look at total patient care. Patient care does not end with what we do, and we need to think beyond us.

[CBEMT]

As professionals we need to look at total patient care. Patient care does not end with what we do, and we need to think beyond us.

I know what happens beyond me- the patient is taken off the board, in many cases before I'm even gone.

A LOT of people get boarded in my area, and when the trauma center is backed up the minor ones could be sitting there for a while (granted they're not all strapped to the board, but that's another story for another day). Even still, I have yet to hear about anyone complaining of or suing over a pressure ulcer that they got from a backboard anywhere near here. Ever.

[nwoparamedics]

As professionals we need to look at total patient care. Patient care does not end with what we do, and we need to think beyond us.

Ahh yes...

Many of, if not all our patients involved in MVC's have to be sent out to the city for a CT to clear the spine and it is common to have them on the rigid boards for upwards of 8 hours. Whether it be sores that come of this, or the fact that the patients cannot remain immobile for that length of time on something soo uncomfortable... maybe it is time we investigate this further.

[akroeze]

I know what happens beyond me- the patient is taken off the board, in many cases before I'm even gone.

A LOT of people get boarded in my area, and when the trauma center is backed up the minor ones could be sitting there for a while (granted they're not all strapped to the board, but that's another story for another day). Even still, I have yet to hear about anyone complaining of or suing over a pressure ulcer that they got from a backboard anywhere near here. Ever.

I did a really quick search (what more can you expect at 0250?) and found this:

We carried out a prospective study to determine the association between immobilization in the immediate postinjury period and the development of pressure ulcers in spinal cord-injured patients following their admission to Charity Hospital, New Orleans. Of 39 patients consecutively admitted to the hospital, 23 (59%) developed a grade one ulcer within 30 days, mostly in the sacral region (57%), the peak time of onset being day 4 postinjury (6/23 cases). In partial support of an earlier retrospective study (Linares HA, Mawson AR, Suarez E, Biundo JJ Jr: Association between pressure sores and immobilization in the immediate post-injury period. Orthopedics 1987;10:571-573), duration of unrelieved pressure prior to ward admission was significantly associated with ulcers developing within the first eight days of injury (P = 0.04), but not with ulcers developing during the entire 30-day observation period (P = 0.09). Time on the spinal board was also significantly associated with ulcers developing within 8 days (P = 0.01), but not with ulcers developing within 30 days (P = 0.09). An unexpected finding was the significant inverse association between systolic blood pressure and the development of ulcers both within 8 days (P = 0.03) and within 30 days (P = 0.02), suggesting that reduced tissue perfusion increases the spinal cord-injured patient's susceptibility to pressure ulcers.

http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsum

[CBEMT]

Of 39 patients consecutively admitted to the hospital, 23 (59%) developed a grade one ulcer within 30 days, mostly in the sacral region (57%), the peak time of onset being day 4 postinjury (6/23 cases).

So 23 people get an ulcer within 30 days of being backboarded, so let's ditch the backboard, because clearly pressure ulcers are worse than spinal injuries.

I don't even know why I'm discussing the merits of a study with 39 patients in it.

[scottymedic]

*scotty goes and hides under a rock* sorry I think I opened a can of worms eeeeeek.

I do agree with the statement of (I'm quite sure there is elements of) sarcasm in pressure sores outweighing spinal injuries. I argued this same point but hey, what do we know? I'd rather have an ulcer on my butt that I know can be healed with grafts etc, rather than the fact I will be crapping in a bag or never walking again, because of not being immobilised properly.

I don't know if you guys overseas carry them, but every officer here is issued a pocket procedures guide. Sometimes I think they are underutilised. Any feelings on that? (cautious change of topic hehe).

Scotty