Monhae Posted February 23, 2009 Share Posted February 23, 2009 Spoken like a man who has not spent much time strapped to a backboard. You are correct. Perhaps I should have put "hurts" in quotes. In truth backboards suck big time. I am a strong advocate to selective spinal immobilization. Truly. Link to comment Share on other sites More sharing options...
CBEMT Posted February 24, 2009 Share Posted February 24, 2009 The patient decides to go to the hospital, I told my partner, who then passed on to fire, that the patient needed to be c spined due to mechanism and airbag deployment. Not good enough. Elderly + some mechanism + possible LOC + hypoglycemic + potentially altered = Good enough. I wouldn't like doing it, but life sucks. Link to comment Share on other sites More sharing options...
iclause Posted February 24, 2009 Share Posted February 24, 2009 in my opinion, yes on c-spine immobilization. air bag deployement, altered mental status, unknown loc... just to name a few.... even though im a new AEMT-I (but have been a basic for + 10 yrs.) if the Fire Dept. Medic says no c-spine / board, then let him tech it. its his arse not mine. Link to comment Share on other sites More sharing options...
ERDoc Posted February 24, 2009 Share Posted February 24, 2009 LOC is not an indication to immobilize. If they did have a loss of consciousness but are now A&OX(whatever number you use) then you can rule them out depending on other findings. I would agree that the changing stories is concerning as is the hypoglycemia. I would say that based on these we could conclude that he has an AMS. Link to comment Share on other sites More sharing options...
zippyRN Posted February 24, 2009 Share Posted February 24, 2009 LOC is not an indication to immobilize. If they did have a loss of consciousness but are now A&OX(whatever number you use) then you can rule them out depending on other findings. I would agree that the changing stories is concerning as is the hypoglycemia. I would say that based on these we could conclude that he has an AMS. it's a decision the intelligent provider will make case by case ... depending o nthe what else found there are strong arguements either way and no amount of armchair quarterbacking will make the right decision ... there is also the issue of immobilisating the elderly becasue of the age related physiologicla changes ... Link to comment Share on other sites More sharing options...
Dustdevil Posted February 25, 2009 Share Posted February 25, 2009 I would agree that the changing stories is concerning as is the hypoglycemia. I would say that based on these we could conclude that he has an AMS. Or else, after initial res gestae statements, and the arrival of the cops, he simply realised that commenting on his memory of the details of the accident wasn't such a good idea after all. Seen that happen a million times. Regardless, decreased blood sugar is expected to change the mental status. Link to comment Share on other sites More sharing options...
tamaith Posted February 25, 2009 Share Posted February 25, 2009 i think the pt should be immobilized . the pt may have damage and just doesn't feel it at that time. better to be safe than sorry. Link to comment Share on other sites More sharing options...
zippyRN Posted February 25, 2009 Share Posted February 25, 2009 i think the pt should be immobilized . the pt may have damage and just doesn't feel it at that time. better to be safe than sorry. i think you need to put a little more criticla anlysis into your posts ? the arguement for immobilisation as it stands - Altered LOC - either from passed out/ knocked out in the collision or simply from the hypoglycaemia the argument against - patient 'passes' whichever selective immobilisation algorithm you choose or passes on everything other than Altered LOC and doesn't appear to have a particular altered LOC on assessment ... - no distracting injury - is there any evidence of the 'heart attack' mentions by the first person on scene ? Link to comment Share on other sites More sharing options...
wrmedic82 Posted February 28, 2009 Share Posted February 28, 2009 Me personally I would have fully immobilized him for a couple reasons 1. He may be altered due to hypoglycemia 2. Adrinaline may mask injuries 3. Just because the patient is walking around does not R/O head, neck or back injuries. 4. Most importantly C.Y.A. Of course everything is a case-by-case basis. It wouldn't cause further harm to fully immobilize the patient. What alot of people get complacent about is the routine stuff. Lets face it almost everyday 911 EMS providers will encounter a MVC once or twice a shift. Its also complacency that brings cause for litigation (in the U.S.) Unless you have a X-ray machine on scene to R/O Fx to head, neck, or spine, C.Y.A. and immobilize the patient. Link to comment Share on other sites More sharing options...
CBEMT Posted February 28, 2009 Share Posted February 28, 2009 So you always backboard everyone you find at an MVA? After all, "CYA." Link to comment Share on other sites More sharing options...
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