Curious. Obviously, the previous standard for spinal injury was full immobilization on a spinal board. BLS v3.3 currently states that those with suspected unstable pelvis should be secured onto a spinal board or breakaway stretcher (Scoop). We are then being referred to the blunt/penetrating trauma standard. There it also states to secure onto a spinal board or breakaway stretcher, and secure the lower extremities to reduce further injury/trauma to the pelvis. My question is, what is the current acceptable standard for this immobilization as per SWORBHP. Should this be full immobilization, 4 straps, headlocks etc? I do not see this written anywhere, and just looking for clarification as no one I ask seems to know the answer. Thanks
As you have mentioned, the instructions on expectations for immobilization can be found in the Spinal Motion Restriction and Blunt/Penetrating Standards. These Standards explicitly describe when to utilize a C-collar, when (and when not to) utilize a spinal board and other nuances based on the mechanism of injury, historical factors and patient assessment. The other elements of how to best immobilize the injured patient are left to paramedic discretion and will vary based on available service equipment. Given this falls under the BLS PCS, SWORBHP Medical Council does not have a prescriptive immobilization method required. We trust your judgement and ability to immobilize your patients with your available resources and direct your inquiry to the education leads at your Service.
There are several aspects to this care as a paramedic including initial extrication from the scene, safe packaging for transport, and possibly transfer from a peripheral hospital to a trauma center. This may mean changing the approach from being able to stabilize while carrying and the consideration of patient comfort and monitoring for transport.