For decades, spinal immobilization (SI) has been the standard practice when moving trauma patients with potential spinal injuries. Indeed, this particular procedure has long been commonplace for patients injured in the backcountry. Spinal immobilization involves the use of various devices, including a long spine board (LSB) and a cervical collar to stabilize the spine and prevent further injury.
However, recent research has called this practice into question. In fact, while current techniques limit or reduce undesired motion of the spine, they do not succeed in fully immobilizing the spine. For this reason, the term “spinal motion restriction (SMR)” has gained favor over “spinal immobilization.”
Both terms refer to the same concept — minimizing unwanted movement of the potentially injured spine. However, while LSBs have historically been used to attempt spinal immobilization, SMR may be achieved using a scoop stretcher, vacuum splint, ambulance cot, or other similar device to which a patient is safely secured.
The National Registry of Emergency Medical Technicians (NREMT) defines the term “spinal immobilization” as the use of adjuncts (LSB, cervical collar, etc.) to prevent movement of the spine. The term “spinal motion restriction” is defined more broadly as attempting to maintain the spine in anatomic alignment and minimizing gross movement — irrespective of adjuncts.
Evaluating the Efficacy of Spinal Immobilization
The effectiveness of the LSB to prevent further trauma to the spine has never been proven in high-level trials. Its use was adopted largely by consensus and not driven by data from any formal studies. An extensive literature review on the history of not using the LSB as a tool concluded that it is ineffective and may be detrimental by delaying time-sensitive treatments for some patients.
A study published by Cambridge University Press examined patient outcomes over a decade during which Emergency Medical Service (EMS) systems decreased backboard use as they transitioned from SI to SMR protocols. The study included (more…)
The suicide rate among emergency medical service (EMS) professionals rose a shocking 38 percent since 2009, according to a study published in the Western Journal of Emergency Medicine. But as shocking as that statistic is, it should come as no surprise.
As an emergency medical technician (EMT) or paramedic, you typically work a five-day rotation of 12-hour shifts (days or nights). You may start the week working Monday and Tuesday and then have Wednesday and Thursday off. You spend half your first day off catching up on sleep, doing chores, and running errands. You’re free the next day, but pretty much alone because everyone you know is at work or school or busy with other normal weekday obligations.
As a result, you likely lack the social connections many of us rely on for emotional support and psychological well-being. Come Friday, Saturday, and Sunday — when your friends and family are off work — you’re back on the job, providing critical medical care in highly stressful situations involving people who don’t always treat you with the respect and appreciation you deserve. And you have to perform this service with a smile on your face, because you don’t want a complaint on your record.
To make matters worse, emergency medical care leaves no room for mistakes. Quality assurance (QA) and quality improvement (QI) programs ensure that Monday morning quarterbacks are always looking over your shoulder to spot mistakes and offer their criticism and sage advice from their comfortable seats along the sidelines.
It’s Getting Worse Instead of Better
You’re thinking about becoming an EMT. Awesome! If you follow through, you will be joining the ranks of today’s modern-day heroes, the frontline of the frontline workers — bona fide life savers!
Emergency Medical Technicians (EMTs) are trained professionals who provide care in critical and emergency situations. Such emergencies can range from simple, routine calls to intense and complex scenarios.
You may show up for a call only to discover that there is no victim, or the person is okay and refuses help, or a patient simply needs transportation from one medical facility to another. On the other hand, you could be called in to attend to the victim of a car accident or a shooting or a heart attack, drowning, mountaineering accident, or drug overdose. You may even have to deliver a baby! You can never predict what will happen over the course of any given shift.
As an EMT, your job responsibilities generally boil down to keeping patients alive using non-invasive medical procedures and transporting them safely to a hospital or clinic where they can receive a higher level of professional medical care. More specifically, you have three fundamental job responsibilities:
- Assessment and stabilization of the patient’s condition
- Basic life support
In this post, we bring you up to speed on the different levels in emergency medicine and credentialing while explaining the basic education and skills required to become an EMT.(more…)