Long Spine Board Immobilization, an Overused Pre-hospital Intervention

10. Taking S.P.’s RA into consideration, what interventions should be implemented to prevent complications secondary to immobility?

It is important to note that there are currently no invasive procedures that Paramedics are trained to do in the field to reduce ICP and early recognition and prompt transport to the nearest hospital with neurological capabilities is the definitive treatment for this type of injury. In our case study, the treating medics were limited in their options for treatment, mostly due to the inability to secure the airway due to the patient locking down his jaw. However they were able to suction some of the fluid and maintain an open airway through manual manipulation and cervical spinal

I recommend everyone using physical techniques of any kind be trained on the risks of positional asphyxiation. Whenever, I physically restrict a person’s movement there is a risk of injury, and no physical holds are 100% safe. In this book, I cover body positioning for physical interventions, standing holds, and seated holds. I do not authorize or encourage a prone restraint without the proper training; and this type of restraint is not covered in this book. However, the SafeClinch Training System does allow for “prone containment” for those organizations allowed to use it; once SafeClinch instructor certification has been achieved. Here is an example of what the prone position looks like. Notice, since the person is in the prone position

Now that I have shared a brief overview of the spinal cord and some statistics about spinal cord injuries, we will look at the past research that has led to the treatments most commonly used today. In 1990, a steroid called dexamethasone was discovered in human trials to preserve some motor and sensory function if administered at high doses within 8 hours of injury. Surgery used to remove fluid, tissue, or bone fragments, or to stabilize fractured vertebrae by fusing bones or inserting hardware has also proven to be one of the most thorough measures to prevent further harm. I received both of these treatments after my accident, and they are the same that have been used for the past decade. Until recently, doctors had no way of limiting such disabilities, aside from stabilizing the cord to prevent added destruction, treating infections, and prescribing rehabilitative therapy to maximize any remaining capabilities.

Football is known as the most popular sport in America. But, little people know about the “Silent Killer.” Football injuries are all too common, one of which being Spinal Cord Injuries. Nobody understands how devastating Spinal Cord Injuries can actually be, until it’s too late.

     This essay is not intended to criticize any emergency medical or hospital staff. I am writing this essay out of concern for patients who come into the emergency room that may have a jeopardized spinal cord resulting from an injury or suspected injury to their cervical spine. I am a certified emergency medical technician, farm-medic instructor and currently a medical diagnostic student doing clinicial's. In the United States each year there are approximately 10,000 reported cervical spine injuries that come into emergency rooms. Motor vehicle accidents account for approximately 45%, falls approximately 30%, the remaining 25% from sports and miscellaneous. Although only a small amount of

Spine injuries hurt a lot for example your spine can pop outback this up. 2-100,000 get spine injuries.

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability among children, adolescents, and adults (Trudel, Scherer, & Elias, 2009, p.41). There are close to 1.4 million individuals a year who are treated with a TBI. Out of this 50,000 of them die. That is 1 out of every 28 people treated for a TBI dies every year. Another 6 out of 28 people are admitted into medical facilities for longer-term care. These number do not take in account the number of people each year with TBI’s who go untreated. However, TBI’s had received little to no support publicly or policy wise until recent years. This increase in attention was due to the increase in TBI’s among military personnel returning home from the wars in Afghanistan and Iraq.

Five criteria must be met which includes authority, information, objectivity, ease of navigation and privacy and security policies. The website used for my research was www.christopherreeve.org. The website met the five criteria. Authority was displayed in several ways. The author, Judith Lubinsky is qualified as an expert in the spinal cord injury field. Judith is responsible for web production and social media for the website. The contact information and credentials for the author was clearly stated. Information is updated daily to keep readers informed of any changes. The information posted is accurate and appropriate for the intended audience. The author provides an unbiased comprehensive review of spinal cord injuries and management. The sponsor for the website is The Christopher and Dana Reeve Foundation. The source of funding does not have an impact on the information provided. The website provides easy navigation with reliable information, treatment options, clinical trials and ways to get involved. The website provided clear privacy and security

The limited space within the vertebrae actually plays an important roll in spinal cord injury. Once the initial injury occurs the body, as with every other part of the body, tries to protect the injured area with swelling. But the swelling occurs within the small confines of the spinal column and causes further damage to the surrounding tissue. It has only recently been discovered how much of an impact this secondary damage has. One of the areas of crucial ongoing research is on what kind of window of opportunity medicine has in treating these types of injuries and still attaining the best recovery.

On March 28th, 2013, the day of my injury, at approximately 10:30 am, I was at my second stop on my route, unloading my truck in Houma, Louisiana. I was located at Cato's Junior/Misses Clothing Store on Martin Luther King Blvd. As I was loading the three carts, a pallet behind me that wasn't properly shrink-wrapped begin to tip over. The truck was filled to capacity and I had no room to step out. As it was heading for me, the carts were blocking me in. I tried to keep it from falling on me by pushing it back up, but to my dismay, it was too heavy. I soon felt something in my lower back snap, and an immediate sharp pain took control of my lower extremities. Primitively, I thought I had just pulled a bad muscle, but as the pain intensified, I

It is appreciated that the given case study contains other factors such as psychological trauma and the impact of blood loss. However this essay is going to explore the efficacy of pre hospital immobilisation utilising cervical collars and extrication/ orthopaedic stretchers, reflecting on an account from the paramedic’s practice. A modified framework of Gibbs Reflective cycle (1988) will be used. Including Description, Feelings, Evaluation, Conclusion and Action Plan. This essay is supported throughout using relevant evidence and seminal work.

If pulling force becomes excessive, injuries can occur. Physical therapists have a low occurrence of injury from cervical traction. The highest rate of injury is observed in chiropractor’s offices (Fabio, R., 1999). The injuries associated with this technique are mostly minor problems like headaches. Some are much more severe in some cases resulting in death. Other more serious conditions include injuries that can occur to the brain stem and spinal

Surgical decompression potentially relieves many symptoms caused by pressure and compression of the spinal cord [120]. The timing of early decompression remains controversial as it is defined differently in animals and human [120]. Fehling et al. suggested that performing an early decompression (6-8 h) in animals enhanced neurological recovery [121]. Notwithstanding, sub-acute surgical decompressions in human patients (24-72 h) have failed to produce satisfactory results due to irreversible tissue damage experienced [30,122].

According to Vickery (2001) however, the spinal board is considered to be the gold standard for spinal immobilisation during the pre-hospital phase of trauma management. For some patients, effective spinal immobilisation is beneficial and can also be vital in preventing the devastating effects of cord damage however it has been suggested that for many the excessive use of this preventative measure may not be prudent or necessary. It has been estimated that over 50% of trauma patients with no complaint of neck or back pain were transported with full spinal immobilisation (McHugh & Taylor 1998). Inappropriate spinal immobilisation may lead to patients experiencing unnecessary pain, skin ulceration, aspiration and respiratory compromise, which in turn may lead to further unnecessary procedures, a longer hospital stay which then incurs increasing costs to the National Health Service (Kwan, Bunn & Roberts, 2001). Shooman & Rushambuza (2009) report that immobilisation is a crucial part of the management of a trauma patient. They believe that if the mechanism of injury is uncertain, the patient should remain immobilised until further imaging even if there are no symptoms of spinal instability after log rolling. However, in a recent study by Pandie, Shepherd & Lamont (2010) they concluded that on its own, standard