EMS Providers should have a basic understanding of skeletal issues like kyphosis, lordosis, and scoliosis, as well as related problems, to provide appropriate care for patients.
Here are a few key points:
Identification: EMS providers should be able to identify these skeletal issues through visual observation and patient history.
1. Kyphosis: Kyphosis refers to an excessive forward curvature of the upper spine, leading to a rounded or hunched posture. It can be caused by several factors, including poor posture, osteoporosis, spinal fractures, or certain medical conditions. EMS providers should be aware of the potential for compromised breathing and mobility in patients with severe kyphosis.
2. Lordosis: Lordosis is an excessive inward curvature of the lower spine, commonly known as swayback. It can be caused by various factors such as obesity, pregnancy, muscle imbalances, or certain medical conditions. EMS providers should be cautious of potential back pain and difficulty maintaining a supine position in patients with pronounced lordosis.
3. Scoliosis: Scoliosis is a medical condition characterized by an abnormal sideways curvature of the spine. This condition can manifest in various degrees of severity and is often idiopathic, meaning the cause is unknown. However, it can also result from congenital factors, neuromuscular conditions, or trauma.
Symptoms: Be aware of common symptoms associated with these conditions, such as pain, limited range of motion, and respiratory difficulties, which can occur due to the abnormal spinal curvature.
Assessment: Conduct a thorough physical assessment to evaluate the severity of the condition, including the degree of curvature, associated deformities, and neurological symptoms.
Stabilization: When immobilizing the patient, EMS providers should consider the unique spinal curvature and use appropriate spinal immobilization techniques to ensure patient comfort and safety. This may involve padding and positioning devices to accommodate the curvature.
Transport: Ensure safe and appropriate transport of patients with these conditions. They may require specialized equipment, such as scoop stretchers or vacuum mattresses, to maintain proper spinal alignment.
Communication: Effective communication with the patient is crucial. Ensure the patient is comfortable and aware of the care being provided. Also, obtain a medical history to determine if there are underlying causes or exacerbating factors related to the skeletal issue.
Related Problems: Understand that these skeletal issues can lead to other medical problems. For example, kyphosis and lordosis can cause respiratory issues by reducing lung capacity, so monitor the patient's respiratory status carefully. They might also be at a higher risk of spinal fractures or other spinal cord injuries. Additionally, scoliosis can sometimes be associated with cardiac and pulmonary complications, which should be considered during patient assessment.
Medication and Pain Management: Be aware of any medications the patient is taking, as well as their potential side effects and interactions. Patients with these conditions may require pain management during transport, so be prepared to administer appropriate pain relief under medical direction.
Special Considerations: Individuals with skeletal issues may require special handling, including assistance with transfers, lifting, or moving the patient. Consider the patient's comfort and any potential complications that may arise from moving them.
Collaboration: Work closely with other healthcare providers, including receiving facilities and specialists, to ensure a seamless transition of care and to address any specific needs related to the patient's condition.
Conclusion
Remember that each patient's needs may vary, so adapt your care accordingly. Additionally, staying updated on current guidelines and protocols for spinal immobilization and care of patients with skeletal issues is essential to providing appropriate care in the field.
It is always important to work collaboratively with other healthcare professionals to ensure optimal care for patients with these conditions.
Further Reading:
Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education
Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson.
Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education
Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey: Wiley Blackwell
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