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Aid for broken tail bone while on lift?

post #1 of 6
1/26/09 at 9:47am
Thread Starter 
I (non-patroller) boarded a chair lift yesterday at Timberline with a 21 yo male showing great pain. Abridged conversation:
"Dude, are you hurt?"
"I think I broke my tail bone again" (terrain park)
"Why did you get on the lift?"
"No one at bottom would get a patroller for me"
(lodge near top of lift)

I imagine that he was dazed with pain and just failed to properly inform someone at bottom that he was hurt. Maybe didn't realize just how bad he was hurt till he had to sit down. Super tough kid, served in Iraq. Getting on lift was a huge mistake (as he quickly realized). He'll remember that agonizing chair lift ride for the rest of his life.

He appeared to be in EXTREME pain. I put the safety bar down and had him lean forward on it to take pressure off his backside and then just tried to keep him talking (does talking help to stave off shock?). I offered to let him sit on my jacket to cushion his backside, but he declined. At the top, I had the lifty stop the chair so we could unload him gingerly (he immediately sprawled onto his belly). Asked lifty to call for patrol. He started crawling away from unload area, so I told him to stop moving. I took off his board and stood there to keep any lift unloaders from accidentally falling on him. A mountain host showed up immediately, followed shortly by MHSP patrollers. He ended up on a backboard.

So, what did I fail to do that would've been helpful? Did I do anything that may have been unwise? For example, looking back, I should've covered him with my jacket while waiting for patrol.
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post #2 of 6
1/26/09 at 12:34pm
You did as much as any guest could do in that situation. Keeping the guest as comfortable as possible 'and talking' to you helped him tremendously. Nice work!

So have you considered being part of a patrol?
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post #3 of 6
1/26/09 at 4:48pm
My motto is to always carry around a pregnecy donut..you never know when you might need one
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post #4 of 6
1/27/09 at 6:05am
I agree with the others- given the situation, there isn't really anything more that you could have done. These injuries are extremely painful when they occur, they're extremely painful as they heal, and a fraction of patients with these injuries will go on to experience some degree of permanent discomfort.

Unfortunately, there is no good way to immobilize or treat an injury to the sacrum and/or coccyx in the field. Most of these patients will end up on a backboard when a patroller and/or EMT gets a hold of them because (a) the tailbone is part of the spine, and we're taught that backboards are for spine injuries; (b) sitting and/or walking may be very painful, and we tend to use a backboard to move patients who can't sit or walk; (c) the patroller or EMT is concerned about the mechanism of injury; or (d) some combination of the above.

A backboard is really not the ideal way to immobilize the injury, and there is some debate in the medical community over whether full spinal immobilization provides any meaningful benefit for these patients. Some say that sacrum and/or coccyx fractures are generally stable fractures, and are unlikely to impinge on any spinal nerves, so the better treatment is to let the patient assume a position of comfort. Others say that the safest course of action is to provide full spinal immobilization until more sensitive areas of the spine, such as the thoracic and cervical spine, can be cleared. This is yet another area where patrollers have to follow local protocols.

If a patroller ever does have to backboard a patient with a significant tailbone injury, it's extremely important to pad both the backboard and any voids between the backboard and the patient's body, because failure to provide adequate support will be very painful for the patient. Give the patient as smooth a sled ride as possible. My view is that unless the patient is hemodynamically unstable, or weather is an issue, this type of injury warrants picking the smoothest way down the hill, even if it's not the fastest.
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post #5 of 6
1/27/09 at 9:44am
Thread Starter 
Quote:
Originally Posted by FRDMFTR View Post
So have you considered being part of a patrol?
Yes, contemplating it. Maybe next season?

Quote:
Originally Posted by MikeN2UZU View Post
Unfortunately, there is no good way to immobilize or treat an injury to the sacrum and/or coccyx in the field. Most of these patients will end up on a backboard when a patroller and/or EMT gets a hold of them because (a) the tailbone is part of the spine, and we're taught that backboards are for spine injuries; (b) sitting and/or walking may be very painful, and we tend to use a backboard to move patients who can't sit or walk; (c) the patroller or EMT is concerned about the mechanism of injury; or (d) some combination of the above.
I think they all applied to the situation.

Quote:
Originally Posted by MikeN2UZU View Post
If a patroller ever does have to backboard a patient with a significant tailbone injury, it's extremely important to pad both the backboard and any voids between the backboard and the patient's body, because failure to provide adequate support will be very painful for the patient. Give the patient as smooth a sled ride as possible. My view is that unless the patient is hemodynamically unstable, or weather is an issue, this type of injury warrants picking the smoothest way down the hill, even if it's not the fastest.
The MHSP patrollers talked amongst themselves (route selection) about how to keep ride as smooth as possible. It was clear they wanted smooth over quick.

Thanks for the info. The medical stuff is the most mysterious (and intimidating) part of patrolling to me. No matter how much you study or see, there'll always be so much more to know.
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post #6 of 6
1/27/09 at 8:47pm
There are obviously a whole range of ways to break a tailbone. When I broke mine it was painful but not immobilizing -- wasn't even sure I had till I went to the doctor a few days later. By the way, it took a very long time to heal completely -- it ached if I sat too long for about a year. No residual symptoms now.
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