Originally posted by Lone Hunter
Let me see if I got his right.A womans in a high speed roll over and she walks to the gurney? Since there was a gurney present I assume there was an ambulance to go along with it.Yet no collar,backboard or manual stabilization???Where was this?I will make sure I drive extra careful around there.Not only do you have to survive the crash,but also the "treatment" of the first responders.
You obviously have a lack of knowledge of emergency medicine, so instead of getting offended by your sarcastic remark, I'll take the time to educate you. First off, it used to be common practice for Medics (I'll use this term for all levels of EMT for this post) to collar and board every patient involved in accidents. This meant that every patient, whether injured or not, went to the hospital in full spinal immobilization (FSI). Lying on that board can be quite uncomfortable, especially when you are taken to a very busy ER adn have to wait for an exam. Well, when the doctors finally got to examine these people, they found the patients to be complaining of soreness all over their back and such. This led to too many unneeded x-rays to rule out spinal injuries when they could have been ruled out in the field. Several studies have been done that determine that a medic is capable of ruling out the possibility of spinal injury. Every service that allows their medics to use selective spinal immobilization has a very detailed set of criteria that has to be met in order to rule out the need for FSI. Several exams are performed on the patient in the field, and given no positive results, the pt doesn't need to be immobilized. Most spinal injuries that occur show immediate neurological deficits. There used to be the fear of the pt with a masked spinal injury that would turn their head the wrong way, and instantly become paralyzed. This is what started the FSI in all wrecks attitude. This is pretty much just a myth or war story in which everybody knows somebody that had a pt do this, but just like urban legends, they weren't based in fact. It was originally geared to make medics scared to not collar and board all patients. It has since been debunked as just an urban legend of EMS since there are no written cases of this happening. If the patient has no point tenderness on palpation of the neck or back, or on turning head from side to side (including touching chin to chest), no numbness or tingling in hands or feet, then they are considered to be safe as long as a few other critera are met.
Here is a website that details all the criteria that need to be met to rule out the need for spinal immobilization.
Don't assume that this lady received a poor level of care because she was walked to the stretcher. I have gone to much worse accidents and had people refuse treatment and transport all together. The way cars are designed now, it is harder and harder to get seriously injured if you wear your seatbelt, even in seemingly serious accidents. Cars are designed to crumple and crush on impact as a way of absorbing the impact. Cars of old that were built like tanks had a big flaw. They transferred all the energy of impact to the people in the car, therefore, the cars faired better than the people in an accident. Cars today are designed so that the people in them fair better than the car. Cars can be replaced....people can't. Rest assured that if you are in a wreck, the medics that come to pick you up have had extensive training in what to do and what not to do.
Mike
Edited to add: I just noticed in your profile you are a firefighter. If you work in an area that backs up EMS, you should know better than to make a comment like that. Heck, it was the firefighters that walked her to the stretcher in the first place. Does this mean that people should be leery of letting firefighters touch them if they get in a wreck? I think you would get offended if somebody suggested that to you. Maybe they don't use selective immobilization where you live, but it is becoming a very common practice throughout the US. You of all people should know that remarks like that do nothing but cause people outside EMS and Fire/Rescue to think that we don't know what we are doing.
