Spinal Immobilization

Question 1

Approprate Pts for LBBB immobilization

Answer 1

A. Blunt trauma w/ ALOC
B. Spinal pain/tenderness
C. Neurologic complaint
D. Anatomic spinal deformity
E. High energy MOI w/ any of the following
1. Intoxication
2. Inability to communicate
3. Distracting Injury

Question 2

Consider MOI

Answer 2

Fall, MVC, struck w/ object, ped struck, assault, bicycle accident, industrial, diving/drowning, H2O accident, etc.
A. Mentation
1. Decreased LOC?
2. EtOH/ Drugs?
3. Loss of consciousness involved?
B. Subjective Assesement
1. Cervical, Thoracic, Lumbar Spinal pain?
2.Numbness/Tingling/Burning/Weakness?
C. Objective Assesment
1. Cervical, Thoracic, or Lumbar deformity or tenderness?
2. Other severe/distracting injury?
3. Pain w/ cervical ROM?

If yes to any, immobilize. If no to all, may treat/transport without spinal immobilization.

Question 3

3. Consider spinal precautions with C Collar and immobilization to gurney

Answer 3

A. Pt ambulatory at scene
B. Pt requiring long transport i.e. IFT
C. Pt where LBB not otherwise indicated.

Minimizing movement and attention to spinal precautions is still paramount!

Question 4

Note

Answer 4

All pts who meet trauma system entry criteria due to blunt trauma mechanism will have, at the minimum, application of a cervical collar. If immobilization to a LBB is impractical and/or leads to patient deterioration, apply a cervical collar and immobolize to the gurney in a supine position