I have many questions regarding the nursing care of the patient with a cspine fx (especially unstable fx) in ICU. I have never done this yet, but am already done with orientation in the neuro ICU, and i fear doing harm. My preceptor told me that if i ever got an unstbale C spine fx that I shouldn't ever move the patient at all untill he had corrective surgery (even though this could be days). She said that you just hope he doesn't poop. My question is, is the back board removed in the ED (I know that is a stupid question and I am sure it is) but if so, how do you go to MRI and such. I would really be interested in any input. I have ordered Joanne HIckey's book, but it has been over a week and it's not here yet. Research on google is difficult, as I keep getting pre-hospital care info and MD care. I promise when i get my book I'll stop asking you all so many questions. I would really appreciate any input on standards of care and protocals for care of the c spine patient.
If you have to move them you have to. I.e. poop, vomit, etc. However, when we have an UNSTABLE (yes, unstable in caps). We don't move them unless absolutely necessary. We had a guy about 6 months ago that was very unstable c3 or 4 I think. Anyway, he started freaking out cause he couldn't take lying on his back anymore. I stayed with him in "intense" therapeutic communication to get him to lay still, while the nurse got an order for Ativan.
Definitely log roll with one person just to manage the neck and an several others to manage the rest. Don't have lots of experience yet, (1 year as tech and 2.5 months as nurse) so I'm sure you'll get better/more advice from others.
In addition, these patients need lots of supervision. As they can injure themselves so easily. My unit has an observation room that has one nurse or one tech present at all times.
Last edit by CarVsTree on Mar 11, '06