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Backboarding policy change


Doczilla

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Oh my eyes, have seen the glory! can I get an amen! ... no, not a long backboard that is the work of Satan!

Long ago New Zealand adopted the position that there is no evidence spinal immobilisation in the form of a rigid board, head blocks, straps and eleventybillion other things is helpful and we use the scoop stretcher and a well fitted hard collar +/- KED for patients in an RTA where appropriate. Australia is very similar although there are minor variances between states and the UK still uses board and blocks.

I have never understood the logic in strapping somebody to a hard, rigid board that is uncomfortable and trying to say its helping them.

I applaud you sir!

Oh, if you want to tube somebody with a cervical collar on, undo the front and use a bougie, but you really should be using a bougie anyway regardless ....

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Bravo Zilla: We have been using a statewide selective spinal immobilization protocol here for over ten years.

It initially came from the wilderness medicine practice and was enlarged after Dr. John burton,et al, did the nexus study.

At the time he was our state medical director and the results were very clear, We have been needlessly packaging patients on rigid backboards and causing complications as you mention.

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I just copy pasted this and emailed it to my boss. She knows our med director so I'll leave it to her to pass it up the chain (from my comfy perch at the bottom):-D Way to go!

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Man, what an amazing start this is to making this change...

Are you OK with this being shared freely Doc? Or at all? And if so, how should it be referenced back to you?

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WOW!!!!! Some very iinteresting reading.

Never heard it expressed this way before, I will also love to cut and paste and send it upward!!

I also echo Dwayne EMTP, in the question of sharing.

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Looks like something worth mentioning finally came out of Ohio, hmm of the four smartest physicians I know two are from Ohio, one is from Michigan and the other is a Kiwi hmm there must be some sort of geographic awesomeness thing in that general Great Lakes area I reckon ... I think it's the influence of the Great Nation of Indiana myself, but I am heavily, heavily biased.

Yes, I am taking the piss.

Please let us know how your policy gets on and I will be watching the NAEMSP for their position statement, I haven't been really thrilled with their other position statements TBH

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Well done. We have been doing "officially" SSI here for 12 years (I wrote the original protocol for my agency) and unofficially for longer. I only have one simple thought on terminology.

I would remove the term "clearing c-spine" from the protocols. At least around here that involves a very specific in hospital standard that requires imaging. Obviously not possible in the field. We instead "selectively immobilize" (wich you did use...good job) or we "defer immobilization according to protocol"

BTW, our trauma surgeons have been pushing for c-collar only immobilization for penetrating trauma without deficits for a few years, but our docs are waiting for an official position paper from the ACS, which is expected at any time now.

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