C-Spine question for canadian Nurse/Murse

[yoyo]

Just to take this discussion along a little further...

There is some literature asking "Why do we collar and backboard?"

According to at least one research team ( http://www.cochrane.org/reviews/en/ab002803.html ) the practice of collar and backboard has never been proved to make a difference either way. In todays 'evidence based medicine' we all collar and backboard because it sounds like a good idea and that's the way "it's always been done"!

:arrow: I'm not suggesting that Paramedics all STOP spinal immobilization today and our protocols aren't going to change overnight. But like my anatomy teacher said - "Open your minds, Do some research for yourselves, and draw your own conclusions."

[CBEMT]

No pun intended (or was it)!

LOL. Unintentional but clearly rimshot worthy!

[Happiness]

Some of the nurses Iv been around do horibble c-spine and some of the doctors just rip off the hardcollar before doing an exam. (just so you know I know great nurses and docs to) This makes me cringe because without exrays you never know what is going on. I asked a doc that i have known for years why the nurses and docs don't seem to know alot about trauma. His explanation was that most of thier trauma training is early in the education cylce and last for approx 6weeks (not alot concidering they go to school for years). by the time they finish school and if they don't specialize in trauma care they loose the skills and forget the knowledge. As for the board issue "better safe than sorry". I now am more likely to use a clam shell for imbolization but if the board is suited better for the call then the board it is.

[Relish]

I've noticed this first hand. After leaving the hospital from visiting a family member, I was a bystander to an old lady who's wheel broke on her walker and she tumbled down a cement step.

I grabbed C-spine after witnessing the fall and noting that it was necessary. Security called for back-up and I was soon surrounded by 15+ docs and nurses, not a damn one asked what really happened or talked to the patient or me! No one took over c-spine, no collar was present when they rolled her (without notifying me- who was at the head, this woman was just all of a sudden rolled) PLUS she was complaining of pain at her left hip- which they rolled her onto! I was in a skirt lying on the cement at 9pm and the doctors and nurses slowly dwindled in #'s as they were all heard to be complaining of how cold it was outside.

Then I was still holding C-spine as we rolled her into Emerg. STILL no one took over. Finally a collar was found-and applied horribly, but they did not apply blanket rolls until I inquired about protocol and c-spine. "oh yeah, I guess we should put blanket rolls" says one nurse.

I could not believe the gong show that I had just witnessed. The whole thing took half an hour- from time of fall to getting her inside the building- she was right outside the front doors! EMS could have driven across town in that amount of time. Still shocked by the stupidity that surrounded me that night.

[a_shane2_go]

One of the few positive expereinces that i've had from hosptial staff was from a local doctor. He told me that one of THE most important things i can do at my level of care is C-spine, C-sping, C-spine. "When you get any, even the smallest feeling in the back of your head that you need it, apply it." I remember him telling me that in my OR practicum when he was anaethetising the patient. And it came in handy when i was first starting out.

[Gusto]

i've often wonderd the same thing myself. a pt ended up transtort via medivac and we got to the nursing station for the transport to the nearest hospital about 1hr away as we enter we noticed the nurse just taking any collar, no measuring and apply this collar that was waaaaayy to big for the pt, it left him like he was looking up, me and my partner just sorta look at each other like.....wow. but you know we just started and who are we to tell the nurse they're not following correct steps to ensure this is a right collar for this pt. either way we just documented that the nurse put on the collar and strapped the pt in and left.

[canadian_ghost]

Something similar happened in my local ER. I was waiting in the ER with our semi stable p/t waiting for them to triage and open a bed for our patient when this 17-19 yr old girl walks into ER looking confused. Nurse sits her down at a chair and advises her not to move at all, apparently the ER was out of hard collars so she looks at me and asks if i can get one out of our car. My partner was attending this call so I was able to leave p/t, I went to the car grabbed a collar and walked back into the ER. I go to hand it to her then she looks at me and asks if I could apply it while she does stabalization, so I tell her I will. I size up and apply the collar to this girl after much screaming from the young girl. Then the nurse tells her to stand up and walks her to towards the x-ray dept. About an hour and a half later I return to the ER and drop off another p/t and ask the nurse how that girl was. Turns out she fractured her neck. Makes you wonder sometimes eh...