2019 EMT Refresher Instructor Manual

C.1.B – Seated Spinal Precautions Vest Extrication

Objectives: 1. Demonstrate how to apply a cervical collar to a patient with a suspected spinal injury. (pp 917–918, Skill Drill 26-5) 2.. Demonstrate how to immobilize a patient with a suspected spinal injury who was found in a sitting position. (pp 911–914, Skill Drill 26-3) 3. Demonstrate the assessment of neurovascular status. (pp 1015–1017, Skill Drill 29-1) 4. Demonstrate the proper use of a Vest Extrication Device.

Setup: You will need your cohort bag. You will also need a KED kit that includes: - KED device Kit with Collar

Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving Deploy your students in one team – one student should be patient, the rest rescuers. The patient is deemed stable during the primary assessment. The students should perform all skills steps on the VEST extrication skills sheet. Please note the following: - DO NOT have them ask males “what side they are dressed on?” - The only required strap order is TORSO > LEGS > HEAD as identified in the manufacturer’s guidelines. Please do not encourage more complex “My Baby Looks Hot Tonight”-type sayings. - Continue rotating students until time is up. Do not stop applying the device even if you think the ‘Students got it”. This product is rarely utilized in the field and it’s likely this practice will be the only practice they will have until they really need to use it. Debriefing: Give students feedback on the application of the device after it is complete. A good vest immobilization will be: - Neutral (the patient will be in neutral position in the device) - Insure neurovascular status is assessed before and after the splint

- Midline (the device will be centered on the body)

- Straps vertical or near vertical in the back (leg straps will be 90 degrees with surface or close to it)

- Cradling the head (the ear flaps will cover a portion of the patient’s ears)