Selective Spinal Immobilization

From Protocopedia
Jump to navigation Jump to search

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


  • 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
  • Unreliable – spinal packaging required
  • Reliable - negative for spinal injury, patient calm, cooperative sober and alert


WHEN IN DOUBT, TREAT AS SPINAL INJURY