2015 Trumbull Memorial Hospital Demo

Spine Injured Athletes Spine Injured Athletes

Clinical Considerations  Current NATA recommendations are designed to guide clinical judgment. They are not law.  Athletes with potential spine injury wearing protective gear complicates lifting, movement, and assessment  Care should be taken to move the spine injured athlete in the most effective way to reduce spine motion.  Patients who are ambulatory on scene should be instructed to sit on the cot.  The intent of the rigid spine board is to facilitate movement and extrication. It provides no benefit and may cause harm to a patient once they are on the ambulance cot.  Every effort should be taken to remove the patient from the rigid spine board as soon as it is possible  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

Significant MOI  Head-to-head collision  Head-down tackle  Axial loading  Recreational vehicles

Questionable MOI  Player down after tackle, unknown injury pattern  Hit/punched above clavicles  Any doubt

Minimal MOI or no energy applied to the spine  Isolated extremity injuries

Spine Motion Restriction Not Indicated

Evaluate need for protective equipment removal Remove if indicated

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

Stabilize injury and transport

Apply Rigid Spine Board or Scoop-Style Stretcher

No Abnormality

Any Abnormality

Consider Pain Management

Move patient to ambulance cot

Continue with transport As soon as it is feasible, remove from rigid device.

Clinical Considerations  Protective equipment removal is indicated in loss of consciousness, airway compromise, suspected hidden injuries, or any life threats.  Be a patient advocate. It is critical that the patient spends minimal time on a rigid spine device.  Weigh the risks/benefits of rigid device removal vs. management of life threats, scene time, patient comfort, and difficulty of removal  Do not logroll the spine injured athlete to a backboard unless found prone; use the NATA recommended 8 person slide technique  If the helmet must be removed, so must the shoulder/torso pads

67

EMR

EMT

AEMT

Paramedic

Extended