One of my nursing students just told me that yesterday she was driving home after an exam and saw a body lying in the middle of the highway. She pulled over, blocking traffic with her pickup truck (I shuddered at the thought...so unsafe! but I just listened - it was done and she lived...). She ran to the body and discovered two other students from our school attending to a woman who had been hit by a car. They stayed with her, she was breathing, but unconscious with visible wounds to the head. They comforted the driver of the vehicle as well - she was incredibly upset. EMS arrived first (it took about 10 minutes - the student said, "It seemed like forever" - seems like a long response time to me for one of the larger cities in a southeastern state. Here's where I freak out. She said, "EMS didn't put her on a backboard or stabilize her head." I can't even grasp this. Can anyone explain this behavior? I'm sure I can find out who was on that particular run, but I want to hear from ya'll first. Maybe I'm wrong, but I always thought that stabilizing the head and neck were the number one priority in an unwitnessed accident/victim unconscious.
Wondering what you would do? Should I try to track them down and report them? This student said several months ago she had called EMS to attend to her husband who was having chest pains and they hadn't known how to do a blood pressure. I am not typically reactionary and try to see all sides of a story, and of course the student could have misunderstood in the stress of the situation.
I have been hard collared after collapsing at an ED triage desk and hitting the ground head first. It was extremely uncomfortable and I understood the need for it.
I have been hard collared after collapsing at an ED triage desk and hitting the ground head first. It was extremely uncomfortable and I understood the need for it.
I love EBP! I posted because I’m seeking new knowledge, so instead of increasing my BP, you’ve set my mind at ease. Thank you!
I'm currently a pre-hospital RN with 20+ years experience. Its easy for us to second guess when we were not on the scene. All I can say is that people who are not trained responders might interpret the situation differently from the EMS personnel.
Difficult to tell - I don't take offense at this post but realize that second hand reports might be a little fuzzy.
Speaking with 15 years of EMS, backboards are no longer recommended and are very seldom used, though each state may have slightly different protocols/guidelines. In my state, the only time you might see EMS use a backboard is for extrication/moving purposes. After that, the patient should be removed from the backboard and transported on just the stretcher. There are also specific algorithms to assess whether or not a patient requires a C-collar. This is all evidence-based practice.
I'm glad you asked here to gain insight about something you are unfamiliar with before reporting the crew.
Specializes in Education, Informatics, Patient Safety.
6 hours ago, traumaRUs said:
I'm currently a pre-hospital RN with 20+ years experience. Its easy for us to second guess when we were not on the scene. All I can say is that people who are not trained responders might interpret the situation differently from the EMS personnel.
Difficult to tell - I don't take offense at this post but realize that second hand reports might be a little fuzzy.
Thank you! I so appreciate that you took the time to read and respond. I'm always learning.
I'm still a paramedic as well as an RN and I have updated information on this subject that is taking a while to work through our interdisciplinary system.
Our EMS medical director, a board-certified Emergency Department physician with a focused interest in pre-hospital emergency medicine, has banned the use of long back board immobilization and we only use the back board as an extrication adjunct for patients. Study after study has shown that motion actually increases on these boards thereby exacerbating any potential injury to the spine. We are instructed to utilize c-collars only if the patient is symptomatic, i.e. neck pain, tingling in extremities, etc.
Under stupid medical TV mistakes. I love it when the character is wearing a soft cervical collar for several days after an incident.
On a serious note. I'm getting confused. If I'm the first upon someone who has suffered a serious fall, been hit by a car, bad tumble off a bike, etc., I assume I would try to keep them somewhat still (unless we were in a dangerous location) until EMS arrive? Maybe not my first intervention, breathing, bleeding, first right?
There's another thread about are nurses taught enough about first aid. We need to merge the two.
Specializes in Education, Informatics, Patient Safety.
22 minutes ago, CKPM2RN said:
I'm still a paramedic as well as an RN and I have updated information on this subject that is taking a while to work through our interdisciplinary system.
Our EMS medical director, a board-certified Emergency Department physician with a focused interest in pre-hospital emergency medicine, has banned the use of long back board immobilization and we only use the back board as an extrication adjunct for patients. Study after study has shown that motion actually increases on these boards thereby exacerbating any potential injury to the spine. We are instructed to utilize c-collars only if the patient is symptomatic, i.e. neck pain, tingling in extremities, etc.
SafetyNurse1968, BSN, MSN, PhD
60 Articles; 529 Posts
I hate to think about that!!! I’m sure you’re right. I make mistakes every day!