Immobilization

[safdrookie]

Does anyone know if there are any studies showing other ways of immobilization besides supine position?
I'd like to present something to my supervisor and see what she thinks.

[Lilly]

Does anyone know if there are any studies showing other ways of immobilization besides supine position?
I'd like to present something to my supervisor and see what she thinks.

depends on what your immobilising and what position you find your patient in.


you can use a device called a KED or TED, used ti immoblise the spine and cervical region in conjunction with a collar, with the patient in a sitting upright position.
like a hard plastic waist coat with plastic spines that wraps around the torso, secured with straps, then a wrap around for the head and neck with forehead and chin straps once the collar is in place.
these were used a lot before the introduction of long boards

hand device when sitting in a car, also carrting handles either side so you can lift up the patient.

Actually used one the other week, as patient on the long board flipped as claustrophobic and ripped every thing of, so placed him in that, and he was quite happy with it.

[Mogollon]

Not exactly what you are looking for; however, you should be able to find out about people experiencing iatrogenic injury from spinal immobilization on a LSB. This is in fact a primary concern with many patient sub-populations, and even a potential problem with healthy patients. Alternatives such as a vacuum mattress could prevent these injuries.

[CombatMedic]

are you looking for information about when do you not board someone or are you looking for alternatives.

The LSB is a time proven effective manner in which we immobilize the spinal cord. One of the biggest problems that I see is that there are too many people who do no do it right or don't know the proper methods.

Here are some of my opinions on this subject.

1: Seat belt style straps that make an X on the chest and one across the legs. These are useless. the patient still slides around. The best effective way to immobilize is with spider straps. Many points of restraint and one long line down the body to ensure you are in a straight line. The biggest problem with the spider straps is that no one uses them enough and that NO ONE puts them away right.

2: Don't forget to pad the voids. Lower back is the big one. This may be why we are having so many problems with back pain after they have been on the board for an hour.

3: Our State has developed a protocol for C-Spine clearance. depending on the system determines if it is a Paramedic Skill or Intermediate. There is a list and if you still feel cautious then you can always board em.

4: KED's are under used because we are in a hurry to get back to the station. We are getting paid to do things right. I admit that I often ignore them and have done things that are not by the book. But know what you have on your trucks and use them to your advantage.

Those are some points that I have. I hope this helps you.

If you are talking about when you find a patient with his neck turned to the side, and it hurts to try and look forward, then splint it where it lies.

[Ditch Doc]

Any method is acceptable, provided is maintains the spine in a neutral position, is appropriate for the situation, does not require manipulation of the spine for placement and it prevents movement. For the most part, the standard LSB is great, but sometimes you need to be creative and macgyver something. Also take into account if immobilizing the Pt would put them at a greater risk than if you did not. (the claustrophobic who is freaking out). Every situation is different, so consider the mechanism, immobilization methods available, if sedation would be appropriate.... you get the idea.

One tool we have had good results with is the Speedboard. Same principle as a KED, but smaller and more uses. A pic is below.

As for the research, I do not know of a study off the top of my head, but if you contact Pro-Lite, they can probably point you in the right direction.

[cwl3gemt]

Any method is acceptable, provided is maintains the spine in a neutral position, is appropriate for the situation, does not require manipulation of the spine for placement and it prevents movement. For the most part, the standard LSB is great, but sometimes you need to be creative and macgyver something. Also take into account if immobilizing the Pt would put them at a greater risk than if you did not. (the claustrophobic who is freaking out). Every situation is different, so consider the mechanism, immobilization methods available, if sedation would be appropriate.... you get the idea.

One tool we have had good results with is the Speedboard. Same principle as a KED, but smaller and more uses. A pic is below.

As for the research, I do not know of a study off the top of my head, but if you contact Pro-Lite, they can probably point you in the right direction.

every fire truck at the track has one of those, and the ambulance too. they work extremely well.

[CombatMedic]

Any method is acceptable, provided is maintains the spine in a neutral position, is appropriate for the situation, does not require manipulation of the spine for placement and it prevents movement. For the most part, the standard LSB is great, but sometimes you need to be creative and macgyver something. Also take into account if immobilizing the Pt would put them at a greater risk than if you did not. (the claustrophobic who is freaking out). Every situation is different, so consider the mechanism, immobilization methods available, if sedation would be appropriate.... you get the idea.

One tool we have had good results with is the Speedboard. Same principle as a KED, but smaller and more uses. A pic is below.

As for the research, I do not know of a study off the top of my head, but if you contact Pro-Lite, they can probably point you in the right direction.

Does anyone have any links or other information about this Speedboard?

[safdrookie]

i was looking more for if there are any other acceptable positions beside supine to secured a pt on a lbb and still maintain spinal immobilzation. I thought i read about dever or somewhere using lateral recumbant position. I don't know I could be way off I was just curious if anyone did anything different or there were any studies about other positions.

[fire medic 328]

As far as I know the supine position is the only approved method for spinal protection. Since its purpose is to maintain proper alignment of the spine the supine position would be the only one that provides a neutral in-line position. As was mentioned earlier pad the voids to maintain spinal alignment and prevent further back pain.

[bakerotfd]

Got married and had two kids. That shit will immobilize your ass like a guinea with concrete shoes. But I have been drinking all afternoon, I could be wrong.