Essay on Pre-Hospital Immobilization of Trauma Patients

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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.
When working on an ambulance for a large ambulance service a case was given of a 27-year-old male who had been assaulted. On arrival at scene the crew were met at the entrance to a block of flats
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Fisher J.D et al (2006) details signs of specific spinal cord injury as: Neck or back pain. Parasthesia and loss of power in the limbs Sensation of burning in the trunk or limbs. Sensation of electric shock in the trunk or limbs. 2

However the patient was immobilised with a cervical collar and extrication board and conveyed to the appropriate receiving hospital as Fisher J.D et al (2006) also states all patients should have initial immobilisation if the mechanism of injury suggests possible spinal injury.
During handover of the patient the paramedic received criticism from a doctor implying unnecessary immobilisation of the patient. The immobilisation equipment was removed in the Emergency Department and the patient subsequently began complaining of cervical spine tenderness.

Initial thoughts and feelings where to do what was in the best interest for the patient by preventing any further injury by immobilisation. At the hospital the patient did not have an x-ray or have his c spine assessed prior to having traction removed. This may have been to the patient’s detriment as he could have suffered further injury. National Institute for Clinical Excellence guidelines (2007) would have been used by the receiving clinician and these guidelines promote the use of the Canadian C-spine Rule developed by Stiell et al (2001) to triage the patient, which

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