Selective Spinal Immobilization

[ny10570 745]

Just heard a rumor that NYS is in the process of approving Selective Spinal Immobilization. If the rumor is correct Regional councils have until the end of the year to develop their protocols and implementation procedures. Its about time.

[effd3918 34]

Just heard a rumor that NYS is in the process of approving Selective Spinal Immobilization. If the rumor is correct Regional councils have until the end of the year to develop their protocols and implementation procedures. Its about time.

I just heard about this in my EMT class. I guess there would be certain tests you would do to attain their mental status or what not like having them push against your fingers equally. Id rather be safe than sorry.

[Guest feraldan]

I'd rather only board and collar those who actually need it vs. those who obviously don't.

Its about damn time.

[effd3918 34]

well your obviously not going to board and collar someone who isnt complaining of any pain but if they have back and neck pain id rather do it opposed to not

[STAT213 332]

http://www.nh.gov/safety/divisions/fstems/...protocolsV3.pdf

look in here under spinal immobilization. It makes life so much easier!! You guys will love having this option!

[ny10570 745]

effd, I understand your trepidation but if you follow the exclusion criteria you catch more than 95% of all spinal fractures and 100% of all unstable spinal fractures. Also remember that this protocol is for exclusion, not for inclusion. So when in doubt they're getting immobilized. The New Hampshire Protocols posted by stat are a great example (pg 98 on the pdf). The only concern is that any time you decrease the need for a skill there is a concern that people lose the skill. People who do not qualify for spinal clearing are at a significant risk for having a significant spinal injury and immobilization needs to be done properly every time. Also intoxication is different from alcohol consumption.

[bil14ga 1]

The protocol is a state protocol and all active EMTs are to be trained in it by the end of the year. Click on the link below and it will give you more (the correct) information on how the DOH expects us to use this. I have been looking foward to this for some time now. It is to be taught in all EMT programs as well. Enjoy and be safe!!!

http://www.health.state.ny.us/nysdoh/ems/spinal/

[Guest alsfirefighter]

Its about time the state got on board with this. I know of some agencies with progressive medical directors that have been allowing this for some time after proper training and policy.

EFFD: If you do a proper assessment you really cannot go wrong. While pain is a significant symptom, the type of pain and where it is, is also equally important. I have never had a patient with a spinal fracture that wasn't in excruciating to intolerable pain. Muscle pain and/or muscle spasm isn't generally indicative of spinal injury, but more times then not results in immobilization.

Being more safe then sorry includes the first rule of all medical practices..first do no harm. It has been proven over many years and many studies that spine boards can actually cause injury and aggravate other pre-existing conditions. My agency has trained us to perform c-spine clearance and to my knowledge for around 5 years we have not missed one single injury that immoblization was the correct choice of action.

[Guest Orpi442]

We had been tought this years ago at Empress. It works well and if you follow it you will find helps out. MY problem is that I find myself using it up in Putnam, Dutchess, & Ulster and find people looking crosseyed at me. Like out on the parkway. Also think aboutthe preg ladies. Keep a open mind and take the class you will like the concept. The other thing is if you have a gut feeling that the person needs to be on a board, put the person on the board.

[WAS967 97]

In typical New York State fashion, the protocols for the spinal immobilization are rather a** backwards. I'd rather see a spinal "clearance" protocol of sorts like the NH one that rules OUT injury, than one that rules IN immobilization. And they specifically say that once immobilization is initiated in the field it can't be discontinued. One overzealous first aider or first responder who may not know the protocol and you end up with a whole lot of unnecessary work and possible agony for the patient.