SPINAL IMMOBILIZATION
ALL LEVELS
You may elect to withhold spinal restriction and discontinue all spinal stabilization efforts if your patient meets ALL of the following criteria. Criteria includes seated patients when considering use of KED. Proceed immediately with spinal stabilization if patient fails to meet ANY of the following:
1. Patient Reliability:
a. Conscious, alert, and well oriented, not under suspicion or the influence of drugs, alcohol, or any other mind-altering substance.
b. Legal adult or emancipated minor, and has no language or communication problems.
c. No suspicion of other major distracting injury.
d. No suspicion of head/brain injury.
2. Assess Spinal Column:
a. No complaints of pain, tenderness, numbness, etc., upon thorough palpation of the entire spinal column.
b. Spinal column has no visible or palpable abnormalities
3. Assess Sensory and Motor Function:
a. No sensory deficit.
b. No motor deficit
4. If the patient fails the above criteria place a C-collar and:
a. If ambulatory assist to stretcher
b. If non-ambulatory use rigid extrication device as needed to move patient to stretcher and then remove device if possible.
5. Utilize C-collar if patient is >65 y/o.
• Long spine boards (LSB) have not been shown to improve patient outcomes. The best use of the LSB is as an extrication device for the unconscious patient.
• Patients should not be immobilized on a LSB, however if unconscious and/or unresponsive maintain use of LSB to aid in patient extrication and transport to hospital by EMS.
• Patients with penetrating trauma and no evidence of spinal injury do not require spinal immobilization.
• Patients who are ambulatory at the scene of blunt trauma in general do not require immobilization via LSB, but may require C-collar and spinal precautions.
• Spinal precautions are very important in patients at risk for spinal injury. Adequate spinal precautions may be achieved by placement of a hard-cervical collar and safeguarding that the patient is secured to the stretcher, ensuring minimal movement. During patient transfers maintain manual in-line stabilization during any transfers.
• If a patient is ambulatory on scene or if they can safely self-extricate, apply a c-collar and allow them to do so.
• No patient should be left on a backboard during transport unless more harm may be done by removal of the board.
• If patient is unconscious or unresponsive may utilize back board and immobilization to facilitate patient transfer.
ALL LEVELS
You may elect to withhold spinal restriction and discontinue all spinal stabilization efforts if your patient meets ALL of the following criteria. Criteria includes seated patients when considering use of KED. Proceed immediately with spinal stabilization if patient fails to meet ANY of the following:
1. Patient Reliability:
a. Conscious, alert, and well oriented, not under suspicion or the influence of drugs, alcohol, or any other mind-altering substance.
b. Legal adult or emancipated minor, and has no language or communication problems.
c. No suspicion of other major distracting injury.
d. No suspicion of head/brain injury.
2. Assess Spinal Column:
a. No complaints of pain, tenderness, numbness, etc., upon thorough palpation of the entire spinal column.
b. Spinal column has no visible or palpable abnormalities
3. Assess Sensory and Motor Function:
a. No sensory deficit.
b. No motor deficit
4. If the patient fails the above criteria place a C-collar and:
a. If ambulatory assist to stretcher
b. If non-ambulatory use rigid extrication device as needed to move patient to stretcher and then remove device if possible.
5. Utilize C-collar if patient is >65 y/o.
• Long spine boards (LSB) have not been shown to improve patient outcomes. The best use of the LSB is as an extrication device for the unconscious patient.
• Patients should not be immobilized on a LSB, however if unconscious and/or unresponsive maintain use of LSB to aid in patient extrication and transport to hospital by EMS.
• Patients with penetrating trauma and no evidence of spinal injury do not require spinal immobilization.
• Patients who are ambulatory at the scene of blunt trauma in general do not require immobilization via LSB, but may require C-collar and spinal precautions.
• Spinal precautions are very important in patients at risk for spinal injury. Adequate spinal precautions may be achieved by placement of a hard-cervical collar and safeguarding that the patient is secured to the stretcher, ensuring minimal movement. During patient transfers maintain manual in-line stabilization during any transfers.
• If a patient is ambulatory on scene or if they can safely self-extricate, apply a c-collar and allow them to do so.
• No patient should be left on a backboard during transport unless more harm may be done by removal of the board.
• If patient is unconscious or unresponsive may utilize back board and immobilization to facilitate patient transfer.