2015 Trumbull Memorial Hospital Demo

Spinal Assessment Spinal Assessment

Clinical Considerations

 C-spine control is used in almost all non-isolated trauma  Anyone who would have traditionally been backboarded will get a c-collar  The intent of the rigid spine board is to facilitate movement  Remove the rigid device prior to arrival at the receiving facility  There is no longer a place for the standing takedown  Patients who are ambulatory on scene should be instructed to sit on the cot

 Providers must still actively use spinal precautions and document what precautions were taken  Providers should use a slide board to facilitate movement between the cot and other surfaces  If any doubt exists whether or not a patient has a spine injury, utilize spine motion restriction

Apply manual c-spine control if any Mechanism of Injury for spine trauma exists

Questionable MOI  High energy impact above the clavicles  Elderly fall from standing

Minimal MOI or no energy applied to the spine  Penetrating trauma with no neuro deficit

Significant MOI  MVC > 60 MPH  MVC Rollover / Ejection  Fall > 3’ / 5 stairs  Axial loading  Recreational vehicles  Car vs pedestrian or bicycle  Vehicle intrusion > 12”

General Neck Pain Age > 65 Language Barrier

NEXUS Criteria Examination  GCS < 15 in any patient  Intoxication  Neurological Deficit  Midline Spine Tenderness  Distracting Injury

Any Abnormality

No Abnormality

Any Doubt

Yes

Spine Motion Restriction (cervical collar, cot, 3 straps)

Spine Motion Restriction Not Indicated

66

EMR

EMT

AEMT

Paramedic

Extended