Answer to Q3.
In the absence of another crew or other assistance the best method is to use
an Orthopaedic (Scoop) Stretcher.
Steve ----- Original Message -----
From: Howard Simpson <[log in to unmask]>
To: Acad-ae-med (E-mail) <[log in to unmask]>
Sent: Friday, July 28, 2000 1:12 AM
Subject: RE: Rapid C-spine clearance
> I'm not sure 'skinny bint' is an appropriate term to use in a public
forum. Your message was effectively conveyed without it.
>
> In answer to your questions:
>
> 1: at Southampton we log roll off the spinal board ASAP, usually on
arrival.
> 2: a doctor does supervise the log roll because a quick primary survey is
needed if someone comes in on a spinal board. Senior nurses also supervise
log rolls off boards for fully conscious, uncomplicated,
cautiously-managed-prehospital cases.
> 3: good question. Any paramedics out there?
>
> Howard
>
> -----Original Message-----
> From: Gautam [SMTP:[log in to unmask]]
> Sent: 27 July 2000 21:35
> To: [log in to unmask]
> Subject: Rapid C-spine clearance
>
> Follow-up to recent discussion re. C-spine immobilization....
>
> Most people would follow the teaching that a spinal board is an
extrication /
> transport device, NOT suitable for prolonged immobilization (pressure
sores,
> discomfort etc.).
>
> Had a well-mannered disagreement with senior (and still much-respected)
sister at a
> previous dept about a young lass who had been bought in with full
immobilization
> after a minor fall. When I arrived for work, the patient had already been
on the
> board, trussed up, immobile, for 3 hours. I threw one of my "usual" strops
about why
> she hadn't been log-rolled off on arrival, to be told that the SHO had
been too busy
> seeing 2 sick medical patients in the previous 3 hours and didn't have
time to
> supervise the log-roll.
>
> There was no pressure on nursing resources at the time (half of them were
at break).
> The patient was a skinny bint, so oddly enough, all her thoracic and
lumbar
> vertebrae were exquisitely tender by now, ended up needing lots of
dangerous XRays
> to exclude #. I could have let her lie on a softer trolley mattress for a
while
> after we removed the board and gave her analgesia and then re-assessed,
but by then,
> she was so fed up she would have taken her own discharge if we hadn't
given her a
> difinitive diagnosis rapidly.
>
> 1) Do other departments give priority (as we usually do) to log-rolling
off boards
> on arrival onto something more humane (e.g. a bed of nails)?
>
> 2) do other departments encourage / allow nursing staff to log-roll off
(even if not
> to formally examine the back) on arrival WITHOUT waiting for a doctor to
be free to
> "supervise"? In my experience, doctors are rarely involved with the
practical
> handling of a log-roll anyway, as they are usually poised to examine the
> undercarriage from the other side.
>
> 3) My understanding is that it takes a minimum of 3 persons to safely
log-roll a
> patient (1 for neck, 2 for body). Can one of you paramedics / pre-hospital
types
> lurking out there tell me how the 2 of you manage safely to get the
patient onto a
> board at the scene?
>
>
>
> Dr G Ray
> Staff Grade
> A&E
> Sussex
> Reply to [log in to unmask]
>
>
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