Thread subject: NEPI :: Pelvic Trauma

Posted by maroju on 07-09-2008 02:37
#9

Straight lift as a quick manouvre to examine the spine doesnot somehow appear to me to be a good idea...
It is a totally uncontrolled manouvre, presumably done by several people, who clearly do not have the faintest idea as to how high to lift or even where to hold the patient. Assuming the patient has a significant spinal injury, you could potentially make it worse!!!
I have resorted to it on a couple of occassions, but that was only in the pre-hospital setting, to get my patients from 'rollover' RTCs where there was no way of getting a spinal board in. This was done purely for extrication. Believe me, it was not a good feeling.
Increasingly, the emphasis on an 'early' log-roll is on the wane. This is mainly to avoid potential 'clot disruption' should there be a significant pelvic injury. If one can rule out any significant injury by FAST and X ray of pelvis, you could then log roll the patient for examination of the back. If the trauma system is well organised in a centre, it shouldn't take more than 10-15 minutes to get all of this done.
(It might be useful to document gross neurology of the patient (extremities/sphincters/priapism) before attempting log-roll)

Edited by maroju on 23-09-2008 12:07