C-Spine question for canadian Nurse/Murse

[mobey]

This is an honest question...PLEASE do not take offence

I was in the ER lately in a fairly major city when a young man walked in complaining of neck pain. The triage nurse told him not to move, and quickly retrieved a C-collar from benieth the desk and applied it immediatly. I was headed for the spine board which is accross the hall fixed to the wall when I noticed she was leading him to a bed instructing him not to turn his head as he walked. Anyway he layed down in the bed and did not move the whole time I was in there (about 10 min). Funny part is none of the other nurse's said boo, or even acted like anything is out of the norm.

The nurse I would guess is less than 30 years old, probably finished school within the last 5.

So the question is are nurses educated in proper spinal immobilization? Is this common practice in canadian ER's or just this one?

[mobey]

Oh ya...Duhh

He was hit in the side of the neck with a baseball and had a substantially large bruise and hematoma visible from accross the room.

[scott33]

From a US perspective...

Any nurse who works triage should have done TNCC at the very least. This covers trauma (including c-spine immoblization) a little more than they would have got in nursing school, at least in the practical sense. There are many other courses and seminars which should be encouraged for those ED staff who are not exposed to too much trauma. Whether or not they apply what they learn is another matter.

Shouldn't be walking with collars, kind of defeats the purpose. If the decision was made that the spine needs to be immobilized, then you were right to go fetch the board.

By the way, it is not uncommon for people to walk into EDs with broken necks.

[HellsBells]

Its funny you know, people seem to think that once the collar is applied the patient is immobilized. I'll always remember something one of my instructors told me.

" the collar is there to remind the patient not to move his head"

[ERDoc]

There is no need for a board. A long board is only for transport purposes. Walking may not have been the best idea, but a long board is not needed.

[a_shane2_go]

Well so far in my short career here in alberta i have noticed that not many nurses take any Spinal precaution when it is in fact needed. Mind u this is rural alberta, however i've showed up to the hospital to transport unstable fractures and the patient is not only in no spinal but also sitting in a chair.... if anything i give credit to X-ray tech's, i've seen some (young one's to) that told nursing staff when the patient comes in for them to stay in spinal or to add it when its needed.

[Richard]

The nurses here in our little hospital call the paramedics when they need someone immobilized in the er.

I don't think they've never been taught, they do it so seldom they would rather have the people who do it all the time do it right the first time.

[CBEMT]

The nurses in our trauma center don't know how that the collar's chin rest has to be unfolded before application. I've corrected that once or twice myself.

And ditto to ERDoc. There is such a thing as overboard.

[ERDoc]

There is such a thing as overboard.

No pun intended (or was it)!

[zippyRN]

There is no need for a board. A long board is only for transport purposes. Walking may not have been the best idea, but a long board is not needed.

i'd agree with that

one of the things i gradually changed practice over at the last ED i worked in was - if you immobilise someone at triage - you do it 'properly'

i.e. maintain neutral alignment , a properly sized collar and transfer them onto a trolley at triage then sandbag/ HEAD blocks and tapes before moving to a exam room