Pacientes Combativos: Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiátricos. 2013 / Protocolo de Atención y Traslado de la Urgencia en Salud Mental. Sistemas de Retención y Tratamiento con Medicamentos

Cuando no teníamos B-52, Ketamina o Buccolam: Midazolam

Restricción Mecánica en un paciente combativo

Protocolo de Atención y Traslado de la Urgencia en Salud Mental

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Para profesionales de emergencias, salud, medicina, desastres, prehospitalaria a nivel global, concentrados principalmente en América Latina y Europa Latina https://t.me/+sF_-DycbQfI0YzJk

Sistema para una rápida y segura contención y transferencia de pacientes alterados, violentos, agresivos o desorientados, para camillas de emergencia

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Pacientes Combativos: Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiátricos. 2013 / Protocolo de Atención y Traslado de la Urgencia en Salud Mental. Sistemas de Retención y Tratamiento con Medicamentos
https://lnkd.in/evhj-Qw

Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiátricos. 2013 by Carmelo López Hernandez www.tescanarias.es
https://lnkd.in/ebFdxCj

Protocolo de Atención y Traslado de la Urgencia en Salud Mental

Post by 

Dr. Ramon Reyes, MD

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Dr. Ramon Reyes, MD 

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Pacientes Psiquiatricos "Pacientes Combativos" en PreHospitalaria 
Manejo con medicimentos

¿Que es B-5-2 = "P-5-2" ?

Es una combinacion de 3 medicamentos que nos permiten tranquilizar (sedar) al paciente de una forma rapida y por un tiempo favorable para poder realizar el traslado de una forma segura para nuestro equipo y para el paciente en si (evitar autolesion). 

1. Benadryl (Difenhidramina = ) 50mg   Benadryl Nombre comercial en EUA (antihistaminico) en España su homologo es el dexclorfeniramina maleato  (Polamamine dexclorfeniramina maleato Inyectable de 5 mg)
2. Haldol (Haloperidol) 5mg 
3. Ativan (Lorazepam) 2mg

B52...
A B52 is an injection of 3 different drugs that is usually used on psych patients, or patients that are being combative.

It is usually given IM (intramuscular)
It consists of the following 3 meds
• Benadryl (Difenhidramina ) 50mg  (
• Haldol (Haloperidol) 5mg
• Ativan (Lorazepam) 2mg
It has a very calming and sedative effect on patients and very often puts them to sleep.
Benadryl: Difenhidramina
Polaramine: dexclorfeniramina maleato  

by Dr. Ramon Reyes, MD

Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiatricos. 2013 
by Carmelo Lopez Hernandez www.tescanarias.es

Enlace para bajar PDF gratis 

Fuente de este manterial
tesanitarias.blogspot.com.es

Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiatricos. 2013 / Protocolo de Atención y Traslado de la Urgencia en Salud Mental

Foto DANSUN
Pacientes Combativos: Tablero Espinal (Camilla de Trauma, Long-Board) Traslado de pacientes psiquiatricos. 2013 / Protocolo de Atención y Traslado de la Urgencia en Salud Mental

SALVAFAST Transfer Sistema de Retención de Pacientes 

Ver informacion en detalles en PDF en el enlace 

http://www.medicaresystem.es/catalogos/salvafast/Salvafast_2017.pdf

ADVERTENCIA: el atado entre las dos manos del paciente detrás o conocido como el llamado "HOG-TIE" que se ve en la imagen no es seguro y nunca debe usarse con restricción, especialmente en en entornos médicos.

PACIENTES COMBATIVOS:

Es importante entender, los pacientes combativos son un peligro para ellos mismos y para el equipo. Pueden sacar líneas, escupir, morder, columpiarse y causar tremendo daño físico/equipamiento.

¡Por favor, que los pacientes sean examinados en busca de armas según sus protocolos locales!

CLAVES: Ten la seguridad lista. Mantenga un plan de salida y tenga acceso a la puerta o salida. Protéjanse a sí mismos y a los equipos.

NOTA: reevaluar rápidamente, obtener nuevos signos vitales y actuar. Obtenga ECG cuando proceda. EtCo2 debe aplicarse y controlarse.

Puede que se necesiten restricciones físicas. Considere la restricción química o RSI (sea cauteloso en shock hemorrágico sin compensación y RSI con paro cardíaco peri-intubación)--> Ketamina, benzodiazepinas, etomidato son algunas opciones.

📷clinicalgate.com

Crédito: @the_resuscitationist

#mentalhealth #psych #psychology #wellness

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Conoce los niveles de la columna que influyen en los músculos con esta infografía que hemos preparado para ti.

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#MSP: El lugar donde médicos, profesionales de la salud y pacientes pueden entrar. #MSPLíderesPioneros

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Vacuum Mattress Splint versus Long Backboard

Vacuum Mattress Splint versus Long Backboard

Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

by ketaminh on September 25, 2013

The Iranian authors claim this is the first RCT study of actual trauma patients , looking at performance of long hard backboard with vacuum mattress splint . IN their discussion they cite several past studies comparing the two methods of spinal immobilisation but note that these were only on healthy volunteers. They also state that as their RCT refutes all the findings of previous studies then further research to try to confirm their findings is warranted!

Surprisingly their findings claim that a hard backboard is SIGNIFICANTLY MORE COMFORTABLE than a vacuum mattress splint!

Not surprisingly, the vacuum mattress splint took longer to apply than the backboard.
The method to measure spinal immobilisation was also crude. Essentially an observer asked the patient to move their cervical and thoracolumbar spine in various directions and a guesstimate of the range of motion from VL ( very low) to VH ( Very high) was recorded ( 5 grades were used )

The major limitation of the study, indeed when comparing any medical device, is the familiarity with the users in the study. It was noted that the long backboard is the traditional method used in prehospital care in Iran. Lack of familiarity with actual prehospital use of the vacuum splint may have biased the recorded observations especially the time to apply as well as the immobilisation degrees measured.

The vacuum mattress splint in my view is more comfortable as its padded and holds the patient more securely in line. It definitely produces more of a sense of being cocooned in and this may elicit claustrophobic feelings in some patients. Perhaps this is the reason why patients rated the vacuum splint less comfortable? Also the unanswered question is how long were these transported patients on the backboard for? I suspect not long as we all know that the longer you spend on a hard surface the less comfortable it gets!

But kudos to our Iranian prehospital colleagues for trying to answer a question that is relevant to our PHARM community. Vacuum splints are expensive and break easily so it is no mean cost to have and use them.

Information from prehospitalmed.com

Vacuum Mattress Splint versus Long Backboard

Prehosp Disaster Med. 2013 Oct;28(5):462-5. doi: 10.1017/S1049023X13008637. Epub 2013 Jun 10.

Long backboard versus vacuum mattress splint to immobilize whole spine in trauma victims in the field: a randomized clinical trial.

Mahshidfar B1, Mofidi M, Yari AR, Mehrsorosh S.

Author information

Abstract

INTRODUCTION:

Patients with possible spinal injury must be immobilized properly during transport to medical facilities. The aim of this research was comparing spinal immobilization using a long backboard (LBB) with using a vacuum mattress splint (VMS) in trauma victims transported by an Emergency Medical Services (EMS) system.

METHODS:

In this randomized clinical trial, 60 trauma victims with possible spinal trauma were divided to two groups, each group immobilized with one of the two instruments. Speed and ease of application, immobilization rate, and the patients' comfort were recorded.

RESULTS:

In this survey, LBB was faster to apply: 211.66 (SD = 28.53) seconds vs 654.00 (SD = 16.61) seconds. Various measures of immobilization were better by LBB. Also, LBB offered a significant improvement in comfort over a VMS for the patient with possible spinal injury. All of the results were statistically significant.

CONCLUSION:

The results of this study showed that immobilization using LBB was easier, faster, and more comfortable for the patient, and provided additional decrease in spinal movement when compared with a VMS.

Comment in

• Author reply: To PMID 23746392. [Prehosp Disaster Med. 2014]
• The Long Backboard vs the Vacuum Mattress. [Prehosp Disaster Med. 2014]

PMID:

 

23746392

 

[PubMed - indexed for MEDLINE]  http://www.ncbi.nlm.nih.gov/pubmed/23746392

Original Research

Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

Babak Mahshidfar^a1, Mani Mofidi^a1 c1, Ali-Reza Yari^a1 and Saied Mehrsorosh^a2

^a1 Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran

^a2 Tehran Emergency Medical Service System, Tehran, Islamic Republic of Iran

Abstract

Introduction Patients with possible spinal injury must be immobilized properly during transport to medical facilities. The aim of this research was comparing spinal immobilization using a long backboard (LBB) with using a vacuum mattress splint (VMS) in trauma victims transported by an Emergency Medical Services (EMS) system.

Methods In this randomized clinical trial, 60 trauma victims with possible spinal trauma were divided to two groups, each group immobilized with one of the two instruments. Speed and ease of application, immobilization rate, and the patients’ comfort were recorded.

Results In this survey, LBB was faster to apply: 211.66 (SD = 28.53) seconds vs 654.00 (SD = 16.61) seconds. Various measures of immobilization were better by LBB. Also, LBB offered a significant improvement in comfort over a VMS for the patient with possible spinal injury. All of the results were statistically significant.

Conclusion The results of this study showed that immobilization using LBB was easier, faster, and more comfortable for the patient, and provided additional decrease in spinal movement when compared with a VMS.

B Mahshidfar, M Mofidi, A Yari, S Mehrsorosh. Long backboard versus vacuum mattress splint to immobilize whole spine in trauma victims in the field: a randomized clinical trial. Prehosp Disaster Med. 2013;28(5):1-4 .

(Received July 29 2012)

(Revised November 24 2012)

(Accepted December 02 2012)

(Online publication June 10 2013)

Keywords

• immobilization; 
• long backboard; 
• prehospital; 
• trauma; 
• vacuum mattress splint

Abbreviations

• EMS:Emergency Medical Services; 
• LBB:long backboard; 
• VMS:vacuum mattress splint

Correspondence

^c1 Correspondence: Mani Mofidi, MD Tehran University of Medical Sciences Rasoul Akram Hospital, Emergency Department Sattarkhan Ave, Nyaiesh St. Tehran, Islamic Republic of Iran E-mail m-mofidi@sina.tums.ac.ir

Footnotes

  Conflicts of Interest: None.

http://journals.cambridge.org/action/displayAbstract;jsessionid=BCEF11F96C0358D8F329416C0658D559.journals?aid=9030584&fileId=S1049023X13008637

Dr. Ramon REYES DIAZ, MD