Couldn't agree more - it seems to me that one of the main justifications for
doctors in pre hospital care is to have someone there to ignore the
hospital- derived protocols when it is in the patient's best interest to do
so.
-----Original Message-----
From: Vic Calland [mailto:[log in to unmask]]
Sent: 07 May 2003 15:47
To: [log in to unmask]
Subject: Re: pre-hospital spinal control
Another aspect of the problem is the person who is trapped upside down
acutely flexed. There are cases of these victims having survived
neurologically intact from the roll-over and then sustained spinal cord
damage without evidence of fracture or dislocation, presumably resulting
from traction or compression ischaemia because the extrication took
longer than the cord could last out.
Delay to get everything just right can cause problems too. I had a chap
the other night in a frontal impact who had tried to get out of the car,
then fallen back on to the seat because he felt too "wobbly". The CD
player was jammed on with inappropriate music blasting into the night
air. I couldn't hear air entry on the left so slid him on to the long
board as a rapid extrication with only in line stabilisation so I could
get him to where I could deal with his chest. Paramedic was upset I
over-ruled her desire to fit a no-neck collar first (clothing removed he
would have been a regular any way). As it was his chest was OK. But if
he really was tensioning then the delay playing with collars would not
have helped.
Life isn't simple out there and it's easy to get bound with guidelines
to the point more harm occurs.
Vic Calland
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]] On Behalf Of Nick Jenkins
Sent: 06 May 2003 21:17
To: [log in to unmask]
Subject: Re: pre-hospital spinal control
OK - not necessarily hypothetical - but it's an open list so let's just
say
it's a case I know of - who knows when / where / who told me / age / sex
etc. etc.? - and all the info you chaps are giving is very helpful -
Thanks
Nick
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