Management of spinal injuries SOP

Question 1

Outline the contents of the spinal injuries SOP

Answer 1

How to risk assess and manage these injuries
Remember these patients may have other significant injuries or a stress response which masks clinically significant spinal injury

Covers:
- Assessment of spinal injury
- Extrication
- Paediatric patients
- Neuro assessment
- Clinical management

Question 2

Describe the assessment for spinal injury

Answer 2

• Control spine during primary if suspicion for injury
• Clearance is high risk use a validated tool
• Immobilise with scoop, straps and three point

Question 3

Describe extrication in the context of spinal injury

Answer 3

• Self-extricate if low suspicion of injury
• Minimise movement if rapid extrication
• Long boards allow extrication but aren’t useful for transportation

Question 4

Describe the particulars of spinal injury in paediatric patients

Answer 4

• Risk benefit when considering distress/agitation
• Most comfortable position
• No collars

Question 5

Describe the aspects of a neuro exam in the context of spinal injury

Answer 5

• Do it prior to sedation/anaesthesia
• Pain, neurology including sensory/motor level, priapism, CVS
• Use spinal injury section

Question 6

Describe the management of suspected spinal injury

Answer 6

• Minimise secondary neuro injury by preserving perfusion
• Monitor ventilation - may deteriorate
• Assess for shock, don’t miss haemorrhage
• May need BP support
• Take to MTC