Over response

Schindlers Pissed wrote: »

I get ya, I'm not second guessing the crew on scene

Sorry now but that's exactly what's going on in this thread. Granted I'm not in a position to look at who posted what now but basically this thread is about second guessing the crew and critising them with one poster more or less saying they failed to work within current CPGs

easygoing1982 wrote: »

Sorry now but that's exactly what's going on in this thread. Granted I'm not in a position to look at who posted what now but basically this thread is about second guessing the crew and critising them with one poster more or less saying they failed to work within current CPGs

Sorry now but it's not We are discussing as practitioners all the possibilitys I've said already the paramedics at the that incident did nothing Wrong
This part of the cpg book in particular is what we are discussing in general and the wider issue of spinal immobilisation being over used

"CPGs are guidelines for best practice and are not intended as a substitute for good clinical judgment. Unusual patient presentations make it impossible to develop a CPG to match every possible clinical situation. The practitioner decides if a CPG should be applied based on patient assessment and the clinical impression. The practitioner must work in the best interest of the patient within the scope of practice for his/her clinical level on the PHECC Register. Consultation with fellow practitioners and or medical practitioners in challenging clinical situations is strongly advised."

Suppose you are taking it that we are having a go at the crew but we are not we are just saying COULD it have been done another way and possibly it could possibly it could not but nothing wrong with discussion
Like just for example I could have turned up to that accident and treated the patient a different way that does not mean I was correct and they are wrong or they are correct and I'm wrong we both could be completely correct possibly we have been going of topic a bit and that is confusing things but I think u are taking up thing wrong easy going

Schindlers Pissed wrote: »

This was total overkill to take a decision to cut up a bystanders car. She was walking around at scene.....any potential damage would be done in the milliseconds during the impact. Spinal rule out, why wasn't it done? Maybe the mechanism was there so we'll give the crew the benefit of the doubt.

If the patient was walking around at scene we can assume she was pretty stable, so why

Cutting the car is NOT standard procedure.

Overkill and dogma was the cause of that car getting cut.

Mycroft H wrote: »

There's also differences in ability between paramedics; experiences, confidence or education. Some may be very up to speed on current research attending lots of CPD opportunities whilst others may just play through the motions. Some may be more risk averse than others too. Yes, there is a minimum standard but there is differences in abilities.

Spinal immobilisation is something that was ingrained into practitioners minds for many many years until it became dogma. Thankfully, evidence based practice is moving us towards selectively immobilising with better clinical tools (canadian c-spine, NEXUS etc) and better hardware; combi-boards, vac-mats. Won't be long before the hard collar is put in the bin too, evidence is mounting against

sjb25 wrote: »

As you said I wasn't on scene but a lot of other options open to paramedics seems strange to rip the roof of a car for a stable patient who had self extricated in the first place and even if the patient had become unstable that quickly dunno if I'd be waiting for a roof to be cut of as I say I wasn't there but seems strange not wrong but bit OTT on the face of it

Schindlers Pissed wrote: »

As previous posters have said, this car was taken apart due to dogma, "it's the way we always did it". The spinal rule out tool isn't just an AP skill, but lots of paramedics seem to think it is. We need to move away from all this spinal thing......vast amounts of research is now out there to back up a move away from boarding everyone.

A patient that gets out of the RTC herself, is ambulatory on scene, has no neurological pathology, but gets a car cut up?

Schindlers Pissed wrote: »

Who said they failed to work within CPGs?? If anything they worked absolutely to the letter of the law regarding CPGs, THAT is the object of the discussion. I suggest you reconsider that opinion.

I'll hold my hand up and say no one said anything about CPGS. I stand by my second guessing comment.

Schindlers Pissed wrote: »

I'm a bit disappointed that "Easy Going" hasn't come back to let us know what he thinks of the latest comments.....

I hope you got over your disappointed.