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West Vancouver First Aid

West Vancouver First Aid

OBJECTIVES:
Selective spine immobilization (SSI) in the EMS setting may be safe while reducing the number of unnecessary immobilizations. An urban EMS system implemented a SSI protocol using Nexus-type indications. Cases of failure to immobilize and of unnecessary immobilization were examined. west vancouver first aid
METHODS:
Falls and motor vehicle crashes (except major trauma) were eligible for SSI. EMS reports were reviewed over one month for SSI indications: altered mental status, drug or alcohol impairment, spine pain or tenderness, neurologic deficits or distracting injuries. Marking of specific check-boxes indicated protocol use. west vancouver first aid Rates of failure to immobilize despite indications and unnecessary immobilization despite lack of indications were calculated. ED records were examined for documentation of significant spine injuries and for morbidity related to immobilization. Differences in rates of failure to immobilize and of unnecessary immobilization, with and without protocol application, were compared using Fisher’s exact chi square. west vancouver first aid

West Vancouver First Aid

RESULTS:
In 165 eligible cases, the protocol was applied in only 48 (29%). west vancouver first aid
Immobilization was indicated in 98 cases. Failure to immobilize occurred in 10 (10%). Two were released at the scene. Of the eight remaining patients none was immobilized in the ED, 2 received x-rays and none had significant spine injuries. The rate of failure to immobilize was 12% without use of the SSI protocol, and 8% when the protocol was applied (NS, p = 0.4).
Immobilization was not indicated in 67 cases. Unnecessary immobilization occurred in 16 (24%), and all were transported. 11 got x-rays, none had significant spine injuries, and none had injury due to immobilization. Duration of immobilization was undocumented. The unnecessary immobilization rate was 58% without use of the SSI protocol, and 12% when the protocol was applied (p < 0.0001).
CONCLUSIONS: west vancouver first aid
An EMS SSI policy was not applied in the majority of eligible cases. When applied, the protocol reduced the rates of failure to immobilize and unnecessary immobilizations, the latter significantly. There were no adverse patient outcomes. Patients were unlikely to receive immobilization in the ED if not immobilized by EMS, despite indications. Patients unnecessarily immobilized by EMS were likely to remain immobilized in the ED and to receive x-rays.west vancouver first aid