Progressive physicians who are current in the literature will have no problem with it, if done properly. It is the current standard of care, and has been for a good while.
That said, there a still un-tested variable in spinal clearance, and that is the setting of the examination. While the results may be statistically consistent in the ER, more than half an hour after the incident, will we get the same consistent accuracy with people laying in the mud, the blood, and the beer, seconds after the incident? While I am completely on board with the concept of SSI, we do still have some work to do to insure that it is actually relevant to field practice.
As an active EMS provider for the last 14 years, I have seen patients that have had spinal column injuries with out complaint of pain and ambulatory on scene,
How ever, I do agree that most of the time I see the patients in the hospital cleared by a physician in the same manner applied in this article.
The patients I have encountered had bone injury to the spine without cord damage; this is only picked up on X-Ray not on a physical exam the majority of the time.
I wouldn’t mind a means of clearing a patient from a backboard in the field that would keep myself and my service protected in litigation through a systematic and approved
Clearance of spinal injury, but until there are clear cut conclusive protocols I’m stuck with back boarding every trauma patient. (Which I hate doing) Given the slow changes that come to EMS
In general, Pre Hospital Care providers are on average held to the highest standards then even the in-hospital providers because if something went wrong it is always blamed on EMS whether it was our
Fault or not, and doctors and nurses come down harder on any minor mistakes by EMS providers then any other providers of care across the boards.
There is the reason for CYA in the field it isn’t pretty but there for a reason.
Prehospital Clearance of Spinal Injury
in Patient Care
Posted
As an active EMS provider for the last 14 years, I have seen patients that have had spinal column injuries with out complaint of pain and ambulatory on scene,
How ever, I do agree that most of the time I see the patients in the hospital cleared by a physician in the same manner applied in this article.
The patients I have encountered had bone injury to the spine without cord damage; this is only picked up on X-Ray not on a physical exam the majority of the time.
I wouldn’t mind a means of clearing a patient from a backboard in the field that would keep myself and my service protected in litigation through a systematic and approved
Clearance of spinal injury, but until there are clear cut conclusive protocols I’m stuck with back boarding every trauma patient. (Which I hate doing) Given the slow changes that come to EMS
In general, Pre Hospital Care providers are on average held to the highest standards then even the in-hospital providers because if something went wrong it is always blamed on EMS whether it was our
Fault or not, and doctors and nurses come down harder on any minor mistakes by EMS providers then any other providers of care across the boards.
There is the reason for CYA in the field it isn’t pretty but there for a reason.
Michael Maczynski EMT-P (Michigan)
As an active EMS provider for the last 14 years, I have seen patients that have had spinal column injuries with out complaint of pain and ambulatory on scene,
How ever, I do agree that most of the time I see the patients in the hospital cleared by a physician in the same manner applied in this article.
The patients I have encountered had bone injury to the spine without cord damage; this is only picked up on X-Ray not on a physical exam the majority of the time.
I wouldn’t mind a means of clearing a patient from a backboard in the field that would keep myself and my service protected in litigation through a systematic and approved
Clearance of spinal injury, but until there are clear cut conclusive protocols I’m stuck with back boarding every trauma patient. (Which I hate doing) Given the slow changes that come to EMS
In general, Pre Hospital Care providers are on average held to the highest standards then even the in-hospital providers because if something went wrong it is always blamed on EMS whether it was our
Fault or not, and doctors and nurses come down harder on any minor mistakes by EMS providers then any other providers of care across the boards.
There is the reason for CYA in the field it isn’t pretty but there for a reason.
Michael Maczynski EMT-P (Michigan)