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Surgery and traumatology: Surgical management of severely injured patients when resources are limited
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
If there is suspected or obvious instability, the patient should not be moved without effective splinting (a vacuum splint or other whole-body splint). If there is severe bleeding from an unstable pelvic fracture, a bandage carefully compressing the pelvic halves together can be used. If the patient is unable to urinate, do not insert a bladder catheter but do a percutaneous cystostomy.
Case 54: Fall in a shop
Published in Eamon Shamil, Praful Ravi, Dipak Mistry, Janice Rymer, 100 Cases in Emergency Medicine and Critical Care, 2018
Eamon Shamil, Praful Ravi, Dipak Mistry
A 75-year-old lady presents to the Urgent Treatment Center (UTC) with knee pain. She was out shopping earlier and fell over onto her knee. She heard a crack as she fell and was unable to stand. A shop assistant called the paramedics who applied a vacuum splint and have brought her into the UTC.
New Immobilization Guidelines Change EMS Critical Thinking in Older Adults With Spine Trauma
Published in Prehospital Emergency Care, 2018
Linda Underbrink, Alice “Twink” Dalton, Jan Leonard, Pamela W. Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M. Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
Outcomes of interest included immobilization type, the presence of a neurological deficit, patient disposition at discharge, and in-hospital mortality/hospice. A wide variety of immobilization devices were utilized throughout the agencies involved in this study. For the purposes of this study, immobilization types were categorized as full spinal immobilization, cervical collar–only immobilization, no immobilization, or other immobilization (Table 1). Full immobilization was defined as the concurrent use of a rigid backboard, scoop stretcher, or full body vacuum splint with a cervical collar and head immobilization device. Other immobilization included a variety of possible head immobilization devices, such as a head block, scoop, or vacuum splint, which may or may not include the use of a backboard or cervical collar. No immobilization was defined as the absence of any rigid backboard, scoop stretcher, full vacuum splint, cervical collar, or head immobilization device of any kind. The presence of a neurological deficit was identified though ICD-9 codes. Patient disposition at discharge was recorded by the trauma registrars and categorized as home, long-term acute care, inpatient rehabilitation facility, skilled nursing facility, other, transfer, and died/hospice.
Spinal Motion Restriction in the Trauma Patient – A Joint Position Statement
Published in Prehospital Emergency Care, 2018
Peter E. Fischer, Debra G. Perina, Theodore R. Delbridge, Mary E. Fallat, Jeffrey P. Salomone, Jimm Dodd, Eileen M. Bulger, Mark L. Gestring
While backboards have historically been used to attempt spinal immobilization, SMR may also be achieved by use of a scoop stretcher, vacuum splint, ambulance cot, or other similar device to which a patient is safely secured.