Spinal Injuries

Question 1

Primary Survey

Answer 1

• Assess & determine need for SMR using the MOI and Nexus criteria
• Stabilize head and neck using manual stabilization
• Assess lvl of consciousness (AVPU scale)
• Assess & manage ABC’s as required (maintaining spinal control)
• Expose and examine injuries - visualize, palpate, where appropriate
• Complete RBS and critical interventions
• Apply O2 based on condition of PT
• Consider the angle & position of the PT

Question 2

Decision Point

Answer 2

Spinal precautions alone do t make PT unstable.
- Consider MOI and Primary Survey results
- If deemed unstable transport immediately, Secondary Survey, treatments & protocols are done on route
- If PT appears stable treat on scene but be prepared to transport immediately if condition deteriorates

Question 3

Load & Transport

Answer 3

Immobilization includes:
- Align neck and head to the neutral position
- Properly size hard collar & head support (foam roll or towel)
- PT placed on immobilization device, backboard or clamshell with straps
- Stretcher straps on the main cot

Question 4

Secondary Survey

Answer 4

• History (SAMPLE & OPQRRRST)
• Vital signs
• Notifications (ISBAR)
• Head to toe and functional inquiry

Question 5

Protocol(s)

Answer 5

Pain management protocol (if indicated)

Question 6

Treatment

Answer 6

• Repeat Pulse, Motor, and Sensory (PMS) assessments should be conducted
• NEXUS rules outline the patients who should receive gentle care, but where no specified Spinal Motion Restrictions (SMR) devices/techniques are required. NEXUS focuses on cervical spine assessment and has been accepted as prehospital spinal clearance protocol
• For PT with suspected head injury elevate head 30 Deg