Like your view on board or not

[Yummymedic05]

When someone comes into our ER in cervical spinal precautions someone, be it nurse or ER tech, must sit with the patient the ENTIRE time until cleared. When the ER is extremely busy it's hard to "get rid" of one person to just sit....and then they want to complain. Don't worry what that nurse said, and in my opinion she made herself, not you, look bad in front of the family.

[Chief1C]

Unless you seen them wreck it, who knows how it happened or what went where. Last summer, we had ATV accidents on a regular basis. Only one person, out of probably close to three dozen, was uninjured. I'd board her, just b/c of the MOI, it doesn't take much to throw a kid off an ATV. The most deadly ones I've seen, all they did was fall off. Adults, fall victim to the "watch this" stories, usually have multi systems trauma. Plywood and picnic tables :roll: do not lead to anything good. Head injuries, Thoracic spine fractures, pelvic injuries and lower extremity fractures or lacerations seem to be the norm for children and ATV accidents around here. She's nine years old, has too much time left in life for a mistake to be made now.

[katbemeEMT-B]

I agree this patient should have been boarded. We have had two accidents recently in which the patient was up and walking around when we arrived. Because of the MOI the decision was made to board. One of the two, who had a massive lump on the head was fine never complained of any pain, numbness, or tingling. Upon xrays of the spine it showed he had two fractured vertebra. They were very tiny hair-like fractures and the pain from the head out weighed the pain in the back. The other patient was fine.

My response to the nurse would have been, "the MOI demanded that we boarded her."

[rock_shoes]

Patient complained of no other injuries. Nothing else noted upon secondary exams. Elbow was swollen and painful. Parents say they heard a 'pop' when they got her up. Patient was alert and oriented. Not sure how fast she was going at the time. No LOC. No numbness or tingling in extremities.

We have numerous ATV accidents a year. Per our protocol, all get backboarded, unless they want to sign a release (as per hospital's orders the last few years). Our thinking, especially with a 9 year old, is if they were thrown off or fell off hard enough to cause a significant injury as described then YES, she needs boarded, which we did. Nurse at the hospital questioned us for quite some time about WHY, and did it in front of the patient's parent. Parent commented that they were glad we took the extra precautions, than not. Nurse was irate that we had her on a backboard for a very minor isolated injury.

As I stated before, she was later taken to another facility for more advanced treatments.

In that case it would have come down to whether or not you deemed the elbow to be a distracting injury. That all depends on the patient as everyone handles pain differently. I suspect it would be considered distracting in a 9 y/o. I certainly wouldn't fault someone for bringing her in on a board.

[Richard B the EMT]

Following local and state policies and protocol, the Method Of Injury would dictate the use of spinal immobilization, and as a newjack to the site noted so accurately, better to do and not need than to not do and need! (Thanks, Velvet Monkey)

By the way, I had never heard of the term of "distracting injury," but I think I get the idea what it is.

[itku2er]

Its better to board and save your A$$ than not to and have a hidden injury you dont know about and get sued for later... just my two cents from the orginal post.

terr

[CBEMT]

Its better to board and save your A$$ than not to and have a hidden injury you dont know about and get sued for later... just my two cents from the orginal post.

terr

Ah yes, CYA medicine... we're really advancing now!!!

[ladyfirefighter36]

Thanks all. We knew we had done the right thing, but sometimes those nurses can really get under your skin (no offense).

I talked with one of the EMS coordinators for the hospital yesterday and explained to him what had happened. He will be talking with the nurse to get his view. The coordinator said we were in the right by what we did and he would make sure that the nurse knew that. I hate to make trouble for anyone, but I also don't want to see another squad in the same situation.

I really appreciate all your views.

[itku2er]

Thanks all. We knew we had done the right thing, but sometimes those nurses can really get under your skin (no offense).

I talked with one of the EMS coordinators for the hospital yesterday and explained to him what had happened. He will be talking with the nurse to get his view. The coordinator said we were in the right by what we did and he would make sure that the nurse knew that. I hate to make trouble for anyone, but I also don't want to see another squad in the same situation.

I really appreciate all your views.

Hey Now i am a nurse too....but we do get attitudal sometimes

and CB you mean you dont practice CYA medicine :?: :?: :?:

[Jon_E]

Good job. Probably would have boarded her myself. Taken PHTLS? There are good nurses and evil nurses. Just as there are good medics and evil medics. As well as nurses that suck @ their jobs, and medics who could use some work. Blow her off and keep doin what youre doin.