#10551 - 06/26/06 12:16 PM
get the cat (II) on the board
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Michael Mcdaniel
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Registered: 09/13/03
Posts: 216
Loc: austin tx
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we had a motorcycle pilot go down at 50-60 mph on I-35 who c/o R shoulder pain and R rib pain adamantly refuse to get on a backboard re: it hurt his ribs/shoulder too much. There was no LOC/ETOH/pain on palp of spine/paralysis/altered mentation. The pt was A&O x3, obeyed commands, and was calm. Despite multiple attempts with various techniques, the pt would not lie on the backboard. My question is, what are some of your ideas to get the pt on the backboard? This was an actual call so if you already know what happened, please refrain from answering now. I'll tell y'all how the whole thing turned out.
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#10556 - 06/26/06 09:23 PM
Re: get the cat (II) on the board
[Re: Aaron Langford]
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Ryan Fouts
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Registered: 04/10/05
Posts: 79
Loc: Hutto, TX
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Dave, I agree with you on giving analgesia to facilitate a necessary treatment (hurray for Fentanyl!!). Doing what it takes to make the pt. confortable, within reason, in order to provide the appropriate care and making sure they don't refuse transport when further evaluation is needed is what we should be and are doing on a daily basis.
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#10557 - 06/26/06 10:57 PM
Re: get the cat (II) on the board
[Re: Ryan Fouts]
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Wes Ogilvie
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Registered: 03/14/03
Posts: 61
Loc: Baja Westlake (Ce-Bar)/North A...
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Maybe I'm missing something, but I'm not seeing anything that would indicate the need for spinal motion restriction under our COGs. Am I not seeing something?
As I understand it, we don't board based solely on mechanism... Right?
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#10558 - 06/26/06 11:54 PM
Re: get the cat (II) on the board
[Re: Wes Ogilvie]
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Sean Norton
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Registered: 03/05/03
Posts: 74
Loc: SanMarcos
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Distracting injury.
Sean
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#10559 - 06/27/06 02:18 AM
Re: get the cat (II) on the board
[Re: Sean Norton]
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Craig Fairbrother
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Registered: 09/23/03
Posts: 187
Loc: Cedar Park
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it is easy to monday morning quaterback here, distracting injury, no distracting injury ect. It really is the call of the medic if the person is really actually "distracted" by the injury or not. We must remember that there can actually be more harm caused to injuries from the board and collar if it is not needed. To answer your question, yoiu can always do a modified c-spine restriction with a half board and the person sitting in a semi fowlers position on the cot.
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#10560 - 06/27/06 05:14 PM
Re: get the cat (II) on the board
[Re: Michael Mcdaniel]
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Michael Mcdaniel
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Registered: 09/13/03
Posts: 216
Loc: austin tx
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we ended up taking this pt to Brack sitting in the captain's chair due to some extenuating circumstances and choices we made onscene. Turned out he had multiple R side rib fxs, R scapula fx, R clavicle fx (we knew that; I just forgot to mention it), lumbar spine fxs, and thoracic spine fxs. I never considered Fentanyl because I didn't think it was appropriate for a multi-system trauma pt. I put this thread here to share some info Brockman and Patrick Murphy shared with me after the call. Fentanyl IS appropriate for a multi-system trauma pt and may have allowed us to properly immobilize this pt. Be very careful disregarding mechanism of injury and don't be afraid to use common sense. Distracting injury is a judgement call. Pain reduction/pt comfort is usually more important than bringing in a pt able to tell the ER everything that hurts due to advances in imaging/diagnostic tools. Patrick, feel free to add additional comments. Craig, the half-board sitting idea probably would have worked for this pt; good idea.
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