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----- Original Message ----- From: "Vikki Chase" <[log in to unmask]> To: <[log in to unmask]> Sent: Tuesday, November 20, 2001 11:57 PM Subject: C-spine injuries (imaging) <snip clinical case> > While I'm on the issue, I thought spinal boards were an extrication device- > they look very uncomfortable and often a patient can have spent over an hour > on them before we've finished x-raying everything we've been asked for. I > asked a Casualty nurse about it, and was unhelpfully informed that the > patient couldn't be removed from the spinal board and clothing couldn't be > cut off until we'd cleared the spine. Somehow that doesn't match with my > experience, and I would be grateful for some clarification from the 'docs'. > As a radiographer I would ideally like to provide the best quality images > possible- and the information I have been given by the A and E staff I work > with seems confusing at times and conflicting at worst! > TIA > Vikki Chase http://www.asancep.org.uk/JRCALC/guidelines/Procedures/PROC_14_LONGB.htm "The concern of placing patients on a board for long periods is centred around pressure area problems. In pre-hospital context, this does not present a practical problem, but care to remove debris from under the patient, and keys or other sharp objects in the patient's pockets, should be taken. Removal from the longboard should be carried out under direction of the responsible hospital staff after suitable patient assessment. " the whole spine board as an extrication device thing makes sense, AIUI at least two ambulance servcies (WYMAS and Notts IIRC) resisted Longboards for a long while, prefering to use alternative immobilisation devices (e.g. KED for vehicle extrication) or scooping onto the ambi trolley and immobilising on the trolley. we hear these stories of people remaining on longboards for long periods, this is a training issue in all likelihood, if people are unwilling to remove people from longboards without getting the imaging done, then the imaging has to be treated as a priority, however if the board is removed prior to x ray you need to be able to provide suitable immobilisation on the A+E trolley until a spinal injury is ruled out. from the JRCALC guideline - what is the definition of 'responsible hospital staff' are people taking that to mean a suitably trained and experienced Nurse or Junior Doc or are we looking at middle grade or senior medical staff? Martyn Hodson [log in to unmask] / [log in to unmask] or [log in to unmask] Student Nurse Sheffield University SJA Ambulance Attendant writing for myself, views expressed are entirely my own, and may not reflect those of Sheffield University or St. John Ambulance , Nationally or locally -Duct tape is like the force, it has a light side and a dark side, and it holds the universe together.