Elderly woman fell. No c-spine?

[Fluffpaw38]

this was a paid EMS company. The woman was complaining of hip, arm and neck pain. That to me seems like a backboard and c-spine situation. I never said Backboard everytime someone falls but with what she was complaining of im not going to stand her up with a hurt hip and neck....camon.....

[ccmedoc]

.... The woman was complaining of hip, arm and neck pain. That to me seems like a backboard and c-spine situation......

Not simply on the complaints...depends heavily on the assessment...there's that crazy word again..The most important of your job. :wink:

[Fluffpaw38]

good point. But if someone is complaining of neck pain and they fell or something...especially an elderly woman. wouldnt you want to back board and collar to cover your ass?

[ccmedoc]

No, not just to cover my ass. There would have to be an elevated index of suspicion to do that to anyone, especially an elderly woman. That board is darn uncomfortable even for you. I doubt she would tolerate it very long anyway. Just depends on the assessment..from mechanism to physical assessment..the whole picture.

[brock8024]

Here is a different view on this and why you would want to assess your patient. How long does it take for a patient to get a bed sore from pressure? I am not just talking about coccyx and ischial wounds but any boney spot like shoulder blades, lower back and hips.

Why is this important? Well find out how long it takes and you will see why a full assessment is needed. If she had to lay on a backboard for a long transport and then lay on a backboard in a busy ER waiting, then she could have more problems then when she started.

Skin break down happens faster in elderly patients due to skin changes and nutrition. Your skin starts to change and get weaker starting if I remember in your 40's. So take a nursing home patient that does not eat well or drink well and does not have much tissue over boney areas you could open a can of worms.

I will back board a lot of my patients if they have not been moved and if they are hurting over the boney part of the neck. I know from my nursing homes that it is a fast trip and the ER doctors are fast about getting them off a board.Most of my patients are off the back board in a matter of less than 5 mins.

[CBEMT]

Don't immobilize someone "to cover my ass." Immobilize them because its the appropriate treatment for their presentation. If you go boarding people just because they fell then you're no better than the guy I know who tried to give O2/ASA/NTG/Albuterol/Lasix/Morphine to a woman with pedal edema.

And don't turn their clothes into handkerchiefs just because it's "OMGTRAUMATHEBOOKSAYSCUTEVERYTHING." If you weren't taught how to assess for pelvic injuries without trauma shears, you need to go retake the class somewhere else.

[firedoc5]

Don't immobilize someone "to cover my ass." Immobilize them because its the appropriate treatment for their presentation. If you go boarding people just because they fell then you're no better than the guy I know who tried to give O2/ASA/NTG/Albuterol/Lasix/Morphine to a woman with pedal edema.

And don't turn their clothes into handkerchiefs just because it's "OMGTRAUMATHEBOOKSAYSCUTEVERYTHING." If you weren't taught how to assess for pelvic injuries without trauma shears, you need to go retake the class somewhere else.

Excellent point. :-k