2019 EMT Refresher Instructor Manual

C.3.B - Supine Spinal Precautions Station 2 – Spinal Precautions and Special Circumstances

Objectives: 1. Demonstrate how to perform manual in-line stabilization on a patient with a suspected spinal injury. (pp 908–909, Skill Drill 26-1) 2. Demonstrate how to immobilize a patient with a suspected spinal injury to a long backboard. (pp 909–911, Skill Drill 26-2) 3. Demonstrate how to apply a cervical collar to a patient with a suspected spinal injury. (pp 917–918, Skill Drill 26-5) 4. Demonstrate the assessment of neurovascular status. (pp 1015–1017, Skill Drill 29-1)

Setup: You will need your cohort bag. You will also need a Longboard Kit that includes: - Longboard with 3 or more straps - Collar - Foam head immobilizer with tape rolls - Deployment: DO NOT LECTURE – your students should be working hands-on within 5 minutes of arriving

Deploy your students in one team – one student should be patient, the rest rescuers. The patient is deemed stable during the primary assessment. The students should perform all skills steps on the Long Board skills sheet. Please note the following: - The only required strap order is BODY > HEAD. Secure the body with two straps crossed over the chest and one over the hips. An additional strap (or a cravat) can secure the legs if available. - Continue rotating students until time is up. Do not stop applying the device even if you think the ‘Students got it”. - You can have the students lift the board at waist-height, but DO NOT have them do any dangerous procedures such as having them spin the board upside down - Debriefing: Give students feedback on the application of the device after it is complete. A good long board will be: - Neutral (the patient will be in neutral position in the device) - Midline (the device will be centered on the body) - Straps securely restraining the heavy parts of a patient (shoulders and hips) SMR: If you feel like your group has mastered traditional spineboard, have them immobilize a patient with the more contemporary Spinal Motion Restriction process of just a collar. Summarized: - Manual stabilization of the head - Application of the collar - Log-rolling a patient onto the board and securing to board with 1-2 straps for safety - Placing the board on the cot and removing the board so the patient lies on the cot with only a collar