Updates Concerning Spine Immobilization and Tourniquets

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So medicine keeps changing. I wrote some articles that need some up dating.

 

TOURNIQUETS:

Tourniquets have improved since I wrote my article on them. They have gotten cheaper and easier to use. Like soldier proof easy. Anything you can do to save time and simplify your application of a tourniquet is going to help.

3 New Tourniquets have arrived on the market that are cheaper and easier to use. They are the H&H TK-4 The Burke RMT and the Pyng MAT

Information about these tourniquets can be found here

 

Now the Cervical Spine Precautions.

The freaking Canadians came up with what are called the NEXUS protocals.

If you can answer NO to ALL of the following then you can rule out C-Spine Imobilzation.

Are there an Focal Neurological Deficits? (Meaning any loss of sensation, numbness or tingling.)

Is there any midline spinal tenderness present? (you have to touch down the spine)

Is there altered level of consciousness present? (is the patient awake and alert and able to answer questions appropriately)

Are they sober? (includes drugs and alcohol)

Are there any distracting injuries? (Any other injuries such as a broken arm or leg)

If you answer YES to any of the above continue to treat them as if they have a spinal injury. If not then you can clinically clear them of possible spinal injury.

Spine Board Imobilization.

Long Spine Boards are on the way out. They are good for extracting temporarily from hostile situations or from vechicals. They are not the prefered method for long transports. For this they suggested molded or air mattress padding be used to help with breathing and pain and the use of soft litters such as a SKED. So those Termarest matress pads you have… Those can be useful.

Links to the appropriate Articles are below.

http://www.jems.com/article/patient-care/research-suggests-time-change-prehospita

http://wildernessmedicine.com/2014/04/tourniquet

http://www.mdcalc.com/nexus-criteria-for-c-spine-imaging/

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About David Black

Trained and Certified: National Registry EMT, Wilderness EMT, US Army 68W, Tactical Combat Causality Care (TCCC), Basic Life Support for Healthcare Workers, Advanced Cardiac Life Support, Pediatric Advanced Life Support, US Coast Guard Medical Person In-Charge, Pre-Hospital Trauma Life Support. International Trauma Life Support. HAM Radio Technician. Trained and Certified to Instruct: Combat Life Saver Instructor and Community Emergency Response Team Trainer. CPR, AED, First Aid.

One thought on “Updates Concerning Spine Immobilization and Tourniquets

  1. David,
    Great stuff on spinal injuries. Assume the worst until assessed as more benign. The question of their sobriety is crucial, so many don’t take this into account and bad things are the result, so make this part of your treatment mantra.
    Cordially,
    Craig

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