Oh man. So You know that little voice in your head that tells you things, no not those voices, but the voices on scenes that tell you "Why don't you do that 12 lead" or "Take a deeper look at that laceration" or "CSPINE!!!!!" Listen to them. Especially the Cspine one. You will never ever get questioned for cspining a patient, but you can always get question as to why you did not cspine one. For those of my blog followers who are not EMS or healthcare workers cspining is when we put a hard collar around the patient's neck and then log roll them or slide them without manipulating the spine (or as little as possible) onto a long boars. This acts as a large splint as sorts to keep the neck and spine in line. This is to minimize further injury and hopefully if done correctly or if the spine isn't already too injured to minimize the risk of paralysis. Okay teaching over.
Okay. So we come across patients all the time that enter that grey area of "to cspine or not to cspine" all the time. Drunk, fell down, answers some questions, but slurring a bit, has a lac above the eye, not c/o neck or back pain. or How about got into a foot pursuit with police, collapse, unresponsive on your arrival, but "didn't really fall that hard" or Found down, no idea how he got there, no idea where he is, no trauma noted. or Seizure pt sitting on floor, still kinda postical, but can't tell you if he fell on the floor or was already sitting. I say ALL of these need Cspine considered if not just done. It takes five minutes. Yeah, its' kinda a pain in the ass, but it's five minutes that can totally save your ass later. You have no idea if that fall caused a C4 fracture to that drunk kid because he's too drunk to know his neck hurts. So you board and collar him and there's nothing that can come back on you when it shows up on his CT scan that he has a broken neck. And you will never have an ER doc fault you for putting your patient in Cspine precautions, if you do, that ER doc should have his head scanned right along with your patient's. So until they start putting Xray machines and CT scanners in the meat wagons, keep on listening to that little voice that screams at you to put that patient ON THE DAMN BOARD. Because it may mean the difference between having a job as a medic or having one as a taxi driver. And I'm talking a real taxi, like little yellow and black ones, not Cabulance that we sometimes are.