To start some essential information is needed provide an overview of the rigid cervical collar from a historical and functional point of view. The initial idea of using a cervical collar for patients with potential or actual cervical spine injuries was put to use in the early 1960’s, in the form of sand bags placed on each side of the head. It was not until sometime in the 1970’s, when the first true extrication collar was used. Since the actual inception of the cervical collar, they have been used in prehospital services during all trauma scenarios. The first cervical collar function is a temporary support for the patients head and head, until the supine position can be obtained for transport. Next, cervical collars are said to reduce compression …show more content…
of the cervical spine and limit the axial loading and unloading of the c-spine that occurs during transport. With many potential positives relating to the use of c-spine collars, there is at the same time a substantial amount of drawbacks.
The assumption can be made that rigid cervical collars would immobilize the cervical spine, when in reality the concepts turns out to be false. Although cervical spine collars have been a major aspect of the EMS world, like many health professions, as new and improved research becomes available tried and true methods are often displaced for better alternatives. Literature Review The use of the rigid cervical collar is a practice that was established with a miniscule amount of information backing the overall efficacy of its use. Collars has been is use and relatively unchanged for over 30 years. Overall use of cervical collars is a widely used practice in around 60 countries, and holds the same importance as airway, breathing, and circulation (Sundstrøm, Asbjørnsen, Habiba, Sunde, Wester, 2014). Cervical collars sole purpose was to prevent any further damage from occurring after initial injury and during extrication. Trauma and potential trauma scenes can present a cornucopia of unique and unseen scenarios. In most situation, although there is protocol set in place to first place an individual to hold manual, inline cervical spine, placing a rigid cervical …show more content…
collar often requires a slight movement of the patients next it order for the collar to be fitted and placed appropriately. This movement brings up a slight contradiction pertaining to what a cervical collar is used for in the first place, which is cervical spine immobilization. With that said, there are a number of studies that show that the initial impact during a trauma scenario can injury the c-spine, and further movement will not contribute to further injury. An example of this is present in the argumentative statement given by Hauswald in 1998 “that the initial impact will cause injury to the spinal cord, and subsequent movement is very unlikely to cause any further damage” (Benger & Blackham, 2009). Although Hauswald’s statement would seem to be contradictor to the purpose of this paper, his knowledge further clarifies why rigid cervical collars are not an essential practice. Additionally, documentation in the form of randomized, controlled studies are lacking or obsolete pertaining the benefits of using a rigid cervical collar (Sundstrøm et al., 2014). A large amount of variables attribute towards the overall success of spinal immobilization, with most being unsuccessful. According to previous research, a simple daily observation clearly shows that when a collar in placed, the placement is often times incorrect, placing the neck in a hyper-extended state. In reality, the use of rigid cervical collar will not prevent axial movement of the cervical spine, and the application of these collars is potentially a dangerous process (Swartz & Del Rossi, 2009). Plus, when traumatic injuries occur to the higher portion of cervical spine containing the C1 through C4 vertebra and accessory joints, the application of rigid cervical collars create separation of the C1 and C2 vertebra. Injuries to the upper portion of the spinal cord are extremely tragic, and the addition spinal motion creating by the application of a rigid cervical collar can lead to unwanted circumstances (Galim et al., 2010 ) When it comes to patient management the most important factors during initial assessment are airway, breathing and circulation.
Those patients that under protocol would require the use of rigid cervical collar, most often need some type of airway adjunct whether that may be an oropharyngeal airway, a nasopharyngeal airway, or through the means of intubation. Studies have shown that cervical spine immobilization techniques, due in fact substantial interfere with airway management. According to Goutcher, even when rigid cervical collars are appropriately place the patients’ mouth opening is reduced by more than 25% (Goutcher & Lochhead, 2005). After a patent airway is established circulation is next crucial aspect, or when it comes to trauma patient the number one aspect. When conducting an initial assessment on a given patient a tell-tale sign of poor circulation is by the observance of jugular vein distention or the absence of JVD. An injury that goes hand in hand with head trauma patients, where the worry is placed on carefully monitoring signs and symptoms of increased or decreased intracranial pressure. Multiple studies have been published about the increased intracranial pressure related to the use of rigid cervical collars. As a result of an increased intracranial pressure, cerebral perfusion is directly affected causing a decrease, which can potential lead to ischemia producing further brain damage. Additionally, a painful stimulus was noted in patients relating
to the collar pressure points (Mobbs, Stoodley, & Fuller, 2002). Summary When developing a conclusion about whether or not rigid cervical collars should be used, that data present needs to viewed in a way to answer the question of what is the actually benefit of using rigid cervical collars instead of alternatives, such as soft collars. After reading the ample amount of information available on this particular topic, there is a clear understanding that addition movement cervical spine after the injury will most not produce any further damage, there simply is not any benefit pertaining towards using rigid cervical collars. In conclusion, there is more research available on the negative aspects of using rigid cervical collars, then actually continuing to put them in to action in all trauma scenarios.
Greer, M. E. (2001, October). 90 Years of Progress in Safety. Professional Safety, 46(10), 20-25. Retrieved April 22, 2014, from http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=5367632&site=ehost-live&scope=site
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture. A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Kyphoplasty- procedure where a balloon is inserted into the vertebrae and covered by cement, it elevates the fracture.
DiRusso S, Sullivan T, Risucci D, Nealon P, Slim M. Intubation of pediatric trauma patients in the field: predictor of negative outcome despite risk stratification. Journal of Trauma [serial online]. July 2005; 59(1):84-91. Available from: CINAHL Plus, Ipswich, MA. Accessed March 7, 2014.
“Summary Report for: 29-2041.00 - Emergency Medical Technicians and Paramedic.” O*Net. 2008. Web. 18 Feb. 2010.
In this case I will discuss evidence based nursing problem which has a very big impact to the nurses which is evidence- based practices for safe patient handling and movement. Evidence-based practice is critically appraised and scientifically proven evidence for delivering quality health care to a specific population. This is very important because it will help me in reduction of injuries that are associated with patient handling. There are very many approaches that can be used or rather are used in patient handling. These includes manual patient lifting, classes in body mechanics, training in safe lifting techniques, and back belts. Amazingly there has been a strong evidence that this methods still they do not help in reducing nurses or caregiver’s injuries.
This assignment will focus on one of the extremely important topics of the many hazards in the healthcare work place that may pose as a threat to my health and safety in the Care Industry.
Symptoms starting from the neck create tension and the muscles began to tighten. The neck area is one of the major problems in modern society in which in the duration of sitting and twisting or bending of the trunk. Risk factors in this particular injury can be divided in three work related categories. Neck flexion, arm posture, arm force is evidence for neck pain and work related issues.( Scandinavian Journal of Work, E...
In October of 1998, the Courant’s survey of the 50 states identified that 142 individuals died in physical restraints or seclusion. Another study was done in four Turkish hospitals from July to September of 2005. The study’s findings were, “Nurses used either wrist, ankle, or whole body restraints at various levels. Those nurses who worked in surgical intensive care units and emergency departments and had in-service training used more physical restraint than did others. Only a third of nurses decided on physical restraint together with physicians and three-fourths tried alternative methods. Nurses reported edema and cyanosis on the wrist and arm regions, pressure ulcers on various regions, and aspiration and breathing difficulties in relation to physical restraint.
There has been debate on whether or not restraints are safe for patients. Tammelleo (1992) states that the use of restraints cause approximately 200 deaths every year, some of which include instances where a restraint was not necessary for the patient. Misuse is another important factor in the safeness and effectiveness of bed restraints. Misuse and tragic accidents have lead to the involvement of the FDA and recommendation calls that every medical institution must have and practice protocols for proper use of restraints (72). Tammelleo goes on to discuss recommended alternatives that should be explored before resorting to the use of restraints. Restraining patients may seem like the easier and quicker way to handle a patient, it is not always the best. Some alternative measures include wedging pads or pillows against the sides of a wheelchair to keep the patient in a good position, soften lights, provide soft music, spend extra ...
inserted into the stomach through the nostrils. Complications include malposition, nasal tissue erosion, sinusitis and is contraindicated in the patients with fracture of base of skull.
The three-month intervention targeted the following areas: improvement of worker health through the involvement of unit managers, implementation of unit-wide safety changes, and worker education. The intervention agenda included three themes: 1) improvement of unit ergonomics and safety, 2) practicing safe patient handling, and 3) enhancing staff physical fitness. Floor safety champions were appointed to guide staff during the implementation of the safe patient handling activities. The program included mentoring sessions with an ergonomic specialist, which focused on increasing awareness of strategies to reduce the risk of injury to the worker and patient. Expanded knowledge, readily available supervisor support, and the improved work environment were associated with reduced worker stress and increased consistency in the implementation of safety techniques among workers (Caspi et al.,
Mulligan, R.P. and R.C. Mahabir, The prevalence of cervical spine injury, head injury, or both with isolated and multiple craniomaxillofacial fractures. Plast Reconstr Surg, 2010. 126(5): p. 1647-51.