Nursing and c-spine procedure

[devil84720]

I am currently and EMT working on becoming a medic. Being such I work with nurses frequently. Recently I saw a nurse do something that is never done on the EMT side. She was performing a log roll procedure on a pt with a cervical injury. The pt had a c6 injury and had a hard collar on. The pt was very large person and they had 5 or 6 nurses to help move him/her. The nurse who was at the head was holding his/her head when they rolled him/her on the left side. When they went to roll back the nurse was not holding the head so I said wait a min until she can get back in position. She said she did not need to he/she had done fine with it before. The pt also was paralyzed from mid chest down and the injury was less than one week old. The pt was being transported to a facility that had an mri that could handle the weight.

In EMS the head is always held and you never let go of it when moving a someone.Is his common in nursing? Is this even a technique nurses are taught? If so can I get a reference to site and what is the proper channel to report this error. I do not want to ruin anyone's career but I feel that it is something that should be corrected for future pt.

[TraumaSurfer]

The injury is now known and steps have probably already been done surgically to stabilize the neck.

Now, before you make any judgment, you need to find out some information about the patient but that might not be easy since this is not your patient. Right now you do not have enough information and are merely going by what you might do for an unknown injury in prehospital care. Even that is controversial and EMS is trying to sort out their own immobilization techniques.

What type of internal repair was done? How often is she coming out of the collar for PT and cervical strengthening? Is the patient supposed to be trying to support their own neck for strengthening and the c-collar is just a reminder to not over do something? Acute rehab of some injuries begins very early so the patient does not lose other function. So don't be so quick to judge since you are trying to compare unknown injuries with known injuries which might have patient directed goals for rehab purposes.

It was EMS which did the studies that have shown certain types of assistive movements by EMTs during c-spine can actually be damaging. You are moving in a way YOU believe the patient wants to move. Look up the studies done by U of Washington.

[meljonumd]

I agree with TraumaSurfer. I'm an OT currently, pursuing my BSN. I've worked in PARC-level trauma units and if the spine is Acute, then the patient is handled with all hands on deck, stabilizing all points.

If the patient has been surgically stabilized, as the above patient possibly was 1 week post injury, then the use of spinal precautions is still used (for several weeks), but the patient is not treated like glass.

The hard collar is stabilizing the neck; holding the head is more for comfort in that position (sidelying).