In light of the recent avalanche of discussion surrounding spinal immobilization in the prehospital environment, presented within this post you will find;
- the original JEMS article that piqued our interest here at rightseatmedicine,
- the new and exciting publication by the Wilderness Medical Society for Spine Immobilization in Austere Environments,
- a video-link courtesy of Gallatin County who have recently adopted an adjusted spine immobilization protocol, and
- numerous other immobilizing menu items that are delicious food for thought.
Research Suggests Time for Change in Prehospital Spinal Immobilization – JEMS March 2013
Wilderness Medical Society with WMS Practice Guidelines for Spine Immobilization in the Austere Environment – Wilderness & Environmental Medicine, 24, 241–252 (2013)
The below video link reviews the thinking and research behind the November 2013 changes to the Gallatin County spinal immobilization protocols (apologies for the sound quality) that pioneers this new approach to the selective immobilization of those whom require it.
The position statement from the National Association of EMS Physicians and American College of Surgeons Committee on Trauma that suggest (amongst other things) the application of a C-collar to those patients ambulatory at scene yet unable to pass your NEXUS/CCSpine algorithm, then ‘firmly attach the patient to the EMS stretcher’.
In closing, a recent article within this April’s (2014) issue of JEMS, that adds further to the forum surrounding ‘over-immobilization‘. And from the Journal of American Emergency Medicine in December 2015, titled The long spine board does not reduce lateral motion during transport – a randomized healthy volunteer crossover trial.
The most important aspect in all of this, being our continued discussion and focus on evidence based medicine supporting the many new, exciting and commonsensical ways in which to manage our patients in the prehospital environment.
We are consistently challenged to push aside our individual bias and preferences yet at the same time, tasked on every call to implement our judgement and experience through flexible treatment guidelines.