We recently had some changes to our protocols for the treatment and assessment of potentially spinally injured patients. In the past we were bound by our guidelines that if a patient in a car accident had even mild neck pain but had a sufficient mechanism of injury, then they had to be collared and fully spinally immobilised - regardless of the absence of significant symptoms.
Paramedics were taking patients in to hospital and despite being reasonably certain that the patient had only a soft tissue injury (...how completely certain can you be about anything?) , the person ended up being probed and prodded in all sorts of ways that are usually reserved for alien abduction stories - this not particularly pleasant for the person and very resource intensive for the hospital who have to allocate time and staff to monitor and "clear" the person's spine before they can be allowed to move freely.
Our new protocol allows us to make a clinical judgement in the field and determine the direction of treatment based on what we find - taking into account the patients history, the mechanism, the symptoms, pre-existing medical conditions, age etc. I think this is a great step in the right direction. It seems to be getting a positive reception at the hospitals too - I'm not seeing the triage nurse groan everytime we bring a minor "whiplash" type injury through the doors.
Actually my own neck is killing me after my last round of shifts...must have tweaked something somewhere. Quick I'd better call someone... :)
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