We have also initiated a similar protocol in our department with our
ambulance service colleagues to address this issue. All patients (other
than those in need of active resuscitation in whom there is no clinical
suspicion of an unstable pelvic fracture) undergo a "therapeutic log roll"
by ambulance/nursing staff irrespective of Dr. availability as soon as they
are handed over in the ED.They subsequently undergo a "diagnostic log roll"
by a clinician in due course. The key to implementation was our ambulance
service clinical advisory group. Our ambulance service like it as they get
their kit back immediately and of course it is good for patients.......
Best wishes,
John Black
John Radcliffe Hospital
Oxford.
-----Original Message-----
From: Steve Meek [mailto:[log in to unmask]]
Sent: 06 September 2002 17:18
To: [log in to unmask]
Subject: Re: Nurse initiated removal from spinal boards
We introduced a nurse protocol for this when I wasin
Bath a few years ago, and Charge Nurse John Sexton
published it and presented it at national meetings. He
will, I'm sure, be pleased to hear from you at ED RUH
Bath BA1 3NG 01225 824002.
steve meek
--- Adrian Boyle <[log in to unmask]> wrote:
> I am trying to reduce the amount of time our
> patients spend on spinal boards. One solution that
> has been put forward is that the paramedics and
> nurses logroll the patient off the board onto the
> couch as soon as the patient arrives (without the
> need for a doctor to be present) and then maintains
> immobilisation. The other advantage of this is that
> the two paramedics assist at arrival (and go away
> with their board) The triaging nurse only needs to
> request one other person to give them a hand with a
> log roll.
> The present state is that a patient is left on the
> board by the triage nurse, the paramedics go off to
> their next job and the patient is not taken off the
> board until the SHO comes to see them, often these
> people are medically fairly well and do not get high
> priorities so the wait can be considerable. It can
> also be a hassle getting a 'log roll posse'
> together.
> What is practice in other departments? can nurses
> and paramedics log roll patients off spinal boards
> without a doctor being present? If anyone has a
> formal (evidence based protocol or guideline) I
> would be very keen to have a look at it.
> Adrian Boyle
>
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