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--- Simon McCormick <[log in to unmask]> wrote: > Adrian, > > Taking this a step further, if a patient is > cooperative and vaguely sensible > then why strap down their head at all? Many of > these patients I leave in > the collar but do not strap them down. instead I > explain to them what > injury they might have and ask them not to move > their heads around. If we > can trust them not to move their bodies can we not > also trust them not to > move their heads? I did the spinal injuries course at Stanmore several years ago. They took us through the nursing of spinal injury patients and they use no collars or strapping at all. I asked them specifically if that included unstable C-spine injuries which it does. Must admit it made my eyebrows raise a bit when I heard that! They see a lot of problems from the pressure sores caused by patients being strapped down for too long on very hard surfaces. Cheers Fred. > > Simon McCormick > > P.S. I've actually seen a number of patients who I > have log rolled off the > spine board early in resus put back on them for > transfer to another > hospital! > > > ----- Original Message ----- > From: Adrian Fogarty <[log in to unmask]> > To: <[log in to unmask]> > Sent: 13 September 2002 00:46 > Subject: Re: Head only taped down in the ED > > > You're quite correct from a technical point of view > Mike. But we're > pragmatic folk in the safe confines of our A&E > departments. We figure that > if the patient is vaguely sensible and co-operative > then their thoracolumbar > spine is immobilised by virtue of them lying quietly > on the trolley, and > their c-spine is sorted out with strapping etc. It's > only the intoxicated > and the downright psychotic ones that'll need their > bodies strapped as well! > And if they're playing up that much after trauma > then they usually need > scanned. Prehospital, you're moving them round a lot > so you need belt n > braces, we're just babysitting them so the body > strapping's not so crucial, > that's all. > > Adrian Fogarty > ----- Original Message ----- > From: Mike Bjarkoy > To: [log in to unmask] > Sent: Thursday, September 12, 2002 9:59 PM > Subject: Head only taped down in the ED > > > Starting a slightly different thread... > > One of my pet hates is the A&E/ED log rolling > patients off of spinal > boards and then taping only the head/neck onto the > trolley. > > While we try to minimise further damage to C-Spine > in the Prehospital > arena it seems that there is an attitude that if we > (the A&E/ED) tape the > 'head only' to the trolley then the patients C-Spine > is safe! > > I believe that the A&E/ED actually go out of their > way. inadvertantly, to > potentially induce as much pressure on a suspect > C-Spine as possible by > letting the heavy body move freely around, while the > head which cannot move > thus inducing potential stress on the poor little > ole' C-spine. > > Does this sound like bad practice only to me? > > Bottom line is - > Is the C-spine cleared - YES, release all straps > (including head) > Is the C-Spine cleared - NO, leave the FULL body > packaged > > Mike Bjarkoy > Paramedic > Sussex __________________________________________________ Do you Yahoo!? Yahoo! News - Today's headlines http://news.yahoo.com