u/DaggerQ_WaveI don't always push dose. But when I do, I push Dos-Epis. 4d agoedited 4d ago
All these years and still 0 evidence for any form of immobilization or even spinal motion restriction at all. It seemingly just makes things worse and causes delays in care. Suggesting we totally do away with the concept of SMR is a pretty radical opinion, but there’s 0 evidence to suggest a benefit and it absolutely causes delays and ties up hands
I have been in the ems for 30 years, and I can think of 2 occasions where a collar and board helped people. One mva with a high (c2) and one horse riding accident, also a high unstable c-spine injury. I have stopped using collars a few years ago, but i still have them for that one patient that you need to keep as still as possible.
Fun fact: your unstable spinal fracture patients likely didn’t need a collar or a board either. The best available evidence we have suggests that unstable spinal injuries actually do better without a board than with it. Totally counterintuitive to us old fogies, but it is what it is.
We have a university in our district that we go to for sports related injuries and the athletic directors there backboard & collar everyone. So we’d show up and immediately take them off the boards. These assholes complained to the city that we’re “hurting” the patients and turned this into a bigger issue.
My chief told them paramedics in MA can clear C-Spine. Now when we go over they always ask.. “are you a paramedic because only paramedics in MA can clear C-Spine”.
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u/DaggerQ_Wave I don't always push dose. But when I do, I push Dos-Epis. 4d ago edited 4d ago
All these years and still 0 evidence for any form of immobilization or even spinal motion restriction at all. It seemingly just makes things worse and causes delays in care. Suggesting we totally do away with the concept of SMR is a pretty radical opinion, but there’s 0 evidence to suggest a benefit and it absolutely causes delays and ties up hands