The guidelines are there for other personnel to use in time of stress, just
like checking a,b,c,d quick easy thinking on your feet, I seen other
ambulance staff at an RTA cars, one parked at traffic lights hit from the
rear, 1 person??? wanted to remove this lady out the side with no other
assistance or precautions, what the lady was trying to say that she was days
post back operation, on the spine!
Full immobilisation might be sometimes an overkill however, it is there
for the patients' precaution / prevention especially in pre-hospital where
time is paramount!
Fred
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, January 05, 2002 6:33 PM
Subject: Re: Spinal immobilisation
> Keith Porter says that he has never seen a significant neck injury from a
rear impact. I have seen several but all except
> one from high energy transfer crashes. This 'pain like a stiff neck'
however in someone who previously had no pain after
> the crash would appear to be a relatively benign manifestation of
musculoskeletal pain. I suspect immobilisation is the
> last thing needed, as I have used the term relatively for a reason; these
are the people who are likely to go on to severe
> symptoms of neck pain and stiffness; by and large the earlier it starts
the worse it will be. If the pain goes on for 3
> months it has an 86% chance of lasting for at least 2 years. (The
oft-quoted Gargan and Bannister paper).
>
> > What would you have done with this patient I encountered recently - in
> > view
> > of current guidelines already discussed?
> >
> > Stationary car hit from behind at less than 20mph. Driver has
> > preexisting
> > back condition, exacerbation of symptoms (leg pain/paraesthesia worsened
> > post RTA), no other injuries, walked unaided from vehicle, conveyed to
> > A&E.
> > Passenger has no previous history, no injuries at time of impact,
> > walking
> > around on our arrival. Ten minutes later develops neck pain "like a
> > stiff
> > neck". No neurological symptoms, on examination has bony midline
> > tenderness
> > approx C7/T1, no obvious paravertebral spasm. I thought best option
> > would be
> > to fully immobilise - patient adamantly refused despite full
> > explanation of
> > potential risks. Fully documented decision, patient advised attend
> > A&E etc
> > but as far as I know had no intention.
> >
> > Thanks,
> >
> > Peter Johnson.
> >
> > _________________________________________________________________
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> >
> >
>
> Best wishes,
>
>
> Rowley Cottingham
>
> [log in to unmask]
> http://www.emergencyunit.com
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