Table 7.
Inductive qualitative content analysis of free-text responses in a paramedic spine survey, with illustrative quotations
| MAIN CATEGORY | TENSION BETWEEN SMR-AS-DIRECTED AND SMR-AS-APPLIED | |
|---|---|---|
| Categories | Complications and solutions in the application of SMR | Conflicting influences on how to apply SMR |
| Sub-categories | SMR causes motion | Direction from protocols and guidelines |
| Adverse effects of SMR | Training in the procedure and higher education | |
| Efforts to minimize patient movement | Past experience with difficult/unusual situations | |
| Suggested improvements | Knowledge of recent research | |
| Influence of workplace culture | ||
| Illustrative quotations | • Patient discomfort with the c-collar seems lead to many cases of patients readjusting, pulling at, attempting to remove c-collar, leading to increased manipulation of the neck [The] “no-neck” [smallest] size seems to help with patient comfort and reduce this | • [Past practice] led to a vast number of unnecessarily boarded patients. Change in protocol and more leeway in critical decision-making during assessment led to improvement in this area |
| • More experience means comfort in defending/rationalizing my choice for SMR….Less willingness to treat in a certain way because “it’s always been that way.” | ||
| • I’ve grown tired of fighting with people who are intoxicated, combative, etc., and … think I can make a case that not wrestling with someone and allowing them to not be immobilized is safer for them than wrestling with someone I suspect is truly injured | ||
| • More research done showing many adverse effects | ||
| • [There is now] less fear in the workplace around disciplinary action towards not utilizing SMR | ||