2015 Trumbull Memorial Hospital Demo

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EMR EMT AEMT Paramedic Extended
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
Significant MOI
 MVC > 60 MPH
 MVC Rollover / Ejection
 Fall > 3’ / 5 stairs
 Axial loading
 Recreational vehicles
 Car vs pedestrian or bicycle
 Vehicle intrusion > 12”
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
General Neck Pain
Age > 65
Language Barrier
NEXUS Criteria Examination
 GCS < 15 in any patient
 Intoxication
 Neurological Deficit
 Midline Spine Tenderness
 Distracting Injury
Any Doubt
Yes
Spine Motion Restriction
(cervical collar, cot, 3 straps)
Spine Motion Restriction
Not Indicated
Any Abnormality No Abnormality