It is appreciated that the given case study contains other factors such as psychological trauma and the impact of blood loss. However this essay is going to explore the efficacy of pre hospital immobilisation utilising cervical collars and extrication/ orthopaedic stretchers, reflecting on an account from the paramedic’s practice. A modified framework of Gibbs Reflective cycle (1988) will be used. Including Description, Feelings, Evaluation, Conclusion and Action Plan. This essay is supported throughout using relevant evidence and seminal work.
When working on an ambulance for a large ambulance service a case was given of a 27-year-old male who had been assaulted. On arrival at scene the crew were met at the entrance to a block of flats by a police officer. The crew where informed that the patient was in a second floor flat and the assailants where no longer on scene. On entering the given address there was blood in the corridor of the unkempt flat. A Primary survey was conducted to ascertain scene safety regarding threats to the crew or patient and to identify any immediate life threatening conditions. Fisher J.D, Brown S.N & Cooke M.W (2006) reinforces this by stating the importance of evaluating Time Critical, Potentially Time Critical or Non Critical features when undertaking the Primary survey. The patient was sat up in the kitchen accompanied by a police officer; he informed the crew that he had been assaulted with a baseball bat.
A secondary survey was undertaken encompassing a patient history and head to toe assessment to identify the extent of the patient’s injuries as stated by I. Greaves, K.Porter, T.Hodgetts and M.Woodard (2006). He was found to have a 2-inch haematoma to the back of the head and a 1inch laceration to the forehead with significant blood loss. The patient complained of a headache but denied any visual disturbance, neck tenderness or neurological deficit. Fisher J.D et al (2006) details signs of specific spinal cord injury as:
Neck or back pain.
Parasthesia and loss of power in the limbs
Sensation of burning in the trunk or limbs.
Sensation of electric shock in the trunk or limbs.
However the patient was immobilised with a cervical collar and extrication board and conveyed to the appropriate receiving hospital as Fisher J.D et al (2006) also states all patients should have initial immobilisation if the mechanism of injury suggests possible spinal injury.
During handover of the patient the paramedic received criticism from a doctor implying unnecessary immobilisation of the patient. The immobilisation equipment was removed in the Emergency Department and the patient subsequently began complaining of cervical spine tenderness.
Initial thoughts and feelings where to do what was in the best interest for the patient by preventing any further injury by immobilisation. At the hospital the patient did not have an x-ray or have his c spine assessed prior...