Selective Spinal Immobilization
Section 6 - TRAUMA
6.03 SELECTIVE SPINAL IMMOBILIZATION
- Consider Mechanism of Injury
- Positive mechanism – Apply c-collar, consider full spinal immobilization
- Negative mechanism – negative for spinal injury, no spinal packaging required
- Uncertain mechanism – continue assessment → begin assessment for spine pain and/or tenderness
- Spinal restriction definition
- At a minimum advise the reliable/cooperative patient to not move
- If patient will tolerate it, place cervical collar on patient
- Place patient on stretcher
- Spinal packaging definition
- Place cervical collar on patient
- Package pt on long backboard as long as it does not deteriorate patient condition
- Assess for spine pain and/or tenderness
- Assessment reveals positive pain/tenderness – spinal restriction required
- Assessment reveals – negative response regarding pain/tenderness → begin motor sensory exam
- Perform motor/sensory exam
- Motor exam upper extremities
- Motor exam lower extremities
- Sensory exam
- Presence/absence of abnormal sensation
- Pain sensation upper extremities
- Pain sensation lower extremities
- Abnormal – spinal packaging required
- Normal – begin reliable patient exam →
- Perform reliable patient exam
- Patient exhibiting:
- Acute stress reaction
- Brain/head injury
- Intoxication
- Altered mental status
- Suffering a distracting injury
- Communications barrier – language, hearing impairment, toddlers, infants
- Patient exhibiting:
- Unreliable – spinal packaging required
- Reliable - negative for spinal injury, patient calm, cooperative sober and alert
WHEN IN DOUBT, TREAT AS SPINAL INJURY