So a friend of mine has had multiple brain surgery’s and as a result he has severe positionional vertigo laying flat, he even look up. It’s so bad that if he leans back or lays on his back he has such bad dizzy spells he will vommit with in 2 minutes. So my question is I know he has a medical Id necklace that says what he has and do not lay flat but what would happen if he is in an accident and they think he has a spinal issue??
I forgot to add when he needs an MRI he has to be sedated
As usual, it depends on where you are.
For the paast umpteen decades, any person with a suspected spinal injury was strapped to a long spine board, a plastic board with handles and tie-down pins around the edge; a cervical collar placed around their neck, and blocks (made of vinyl wrapped foam) strapped next to their head. It prevented any movement of any vertebrae, lest the movement damage the spinal cord. It’s also super uncomfortable.
As medicine is mostly based on research and numbers, a bunch of studies over the past ten years or so have found that an incredible percentage - like 99-plus - of patients that have been immobilized had no need to be. We on the prehospital side used to get irritated when we’d board and collar someone in a car accident, only to watch the ER doctor ask the patient “does your neck hurt?” and pull off the collar. No x-ray, no CT, just one question. If he can trust the patient’s answer to that question, why don’t we just ask them that in the first place and save everyone a lot of time and discomfort?
Now we can. In a number of states EMTs can screen patients for spinal injuries in the field and determine whether immobilization is needed. Essentially, if the patient says their neck or back doesn’t hurt, we’re not boarding them. Even if we immobilize, we’re not strapping them to a long board, we have gone back to a device called a “scoop stretcher” which we only use to move the patient to a regular stretcher. If the patient can communicate their comfort, we can position them how they’d like (within limits). It’s much simpler now, and based on whatthe patient is presenting with.
Other states are still requiring old-school board and collar, which will eventually change.
In short, if he can communicate his wishes, it shouldn’t be an issue. Even if he can’t, depending on the state, long boards and c-collars are going away. If he vomits, it’s just one more thing to tend to (for him and cleaning the rescue out).
Just like triaging multiple patients at a mass-casualty event where the most serious ones are treated first, the potential spinal cord injury supersedes vertigo/vomiting as a spinal cord injury is life-impacting.
If a spinal injury is suspected / possible the patient will be boarded & collared. If the patient vomits, patient & board can be turned on their side as one unit to prevent aspiration.