Spinal Motion Restriction Standard (SMR) Flashcards
Consider SMR for ANY pt with a _______ ______ or ______ ______ ______ based on MOI…..
potential spine or spinal cord injury based on MOI
What MOI’s require SMR (9 diff ones)
any trauma associated with neck or back pain
sports accidents (impaction and falls)
diving incidents and submersion injuries
explosions, other types of forceful acceleration/deceleration injuries
falls
pedestrians struck
electrocution
lightning strikes or
penetrating trauma to the head, neck or torso
Determine if pt meets ANY risk criteria as follows:
neck or back pain
spine tenderness
neurologic s/s
altered LOC
suspected drug or alcohol intoxication
a distracting injury
anatomic deformity of the spine
high energy mechanism of injury
- fall from elevation higher than 3 feet/5 stairs
- axil loading to the head
- high speed motor vehicle collisions (>100km)
- hit by a bus or large truck
- motorized/ ATV recreational vehicles collision
- bicyclist struck collision or
- >=65 yrs old fall from STANDING!!
Spinal and extrication boards should primarily be used as _____________/_____________ devices
EXTRICATION & LIFTING
Pt’s with SMR can be placed in what position on the stretcher?
Semi-sitting or supine
C- Collars should be placed on pt prior to movement, true or false?
TRUE
When can spinal boards or adjustable break away stretchers remain in place?
If the paramedic deems it safer/more comfortable for the pt and the hospital is less than 30 minutes away!
When can a pt stand and pivot out of a car with applied SMR?
pt in a vehicle with an isolated neck injury or back pain and no neurological s/s or s/s of significant trauma
If a pt has penetrating trauma to the HEAD NECK OR TORSO AND the pt has NO…. (6 things list them off) then do not apply SMR !!!
NO spine tenderness
NO neurological s/s
NO altered LOC
NO evidence of drug or alcohol intoxication
NO distracting distracting injury and
NO anatomic deformity of the spine
do not apply SMR
Does applying SMR mean that the paramedic has “CLEARED the spine” for blunt trauma patients??
NOPE, using SMR does not mean the paramedic has “cleared” the spine for blunt trauma patients. the paramedic must at all times manage the patient to minimize spinal movement.
Spinal boards or breakaway stretchers may remain in place if the paramedic deems it more ______ / ______ for the patient and the transport time is <30mins!!
safer and more comfortable
When would you leave a pt on the extrication device??
PELVIC#’s
If a patient is already on the spinal board prior to EMS arrival what should we do as paramedics arrivng on scene?
Assess for SMR as per the standard, unless otherwise required, SMR may be modified to meet this standard.
If you have a combative patient and they take the collar off what do we do??
DOCUMENT!!!