Current prehospital practice is to apply spinal immobilization liberally in cases of suspected neck or back injury. Rigid cervical collars, long backboards, and straps remain the standard implements for immobilizing supine patients. Tape, foam blocks, and towels can complement the basic items and improve stability.
When should you use spinal immobilization?
Patients who should have spinal immobilization include the following:
- Blunt trauma.
- Spinal tenderness or pain.
- Patients with an altered level of consciousness.
- Neurological deficits.
- Obvious anatomic deformity of the spine.
- High energy trauma in a patient intoxicated from drugs, alcohol, or a distracting injury.
What is spinal immobilization and why is it used?
Background: Spinal immobilisation involves the use of a number of devices and strategies to stabilise the spinal column after injury and thus prevent spinal cord damage. The practice is widely recommended and widely used in trauma patients with suspected spinal cord injury in the pre-hospital setting.
When should you backboard a patient?
Appropriate patients to be immobilized with a backboard may include those with: o Blunt trauma and altered level of consciousness; o Spinal pain or tenderness; o Neurologic complaint (e.g., numbness or motor weakness) o Anatomic deformity of the spine; o High energy mechanism of injury and: ▪ Drug or alcohol …
What circumstances would keep you from performing spinal motion restriction?
Distracting circumstances or injury (e.g., long bone fracture, degloving, or crush injuries, large burns, emotional distress, communication barrier, etc.) or any similar injury that impairs the patient’s ability to contribute to a reliable examination.
Why is C spine immobilization important?
The theory behind this is that spine immobilization prevents secondary spinal cord injury during extrication, transport, and evaluation of trauma patients by minimizing movement.
What is the C spine?
About the cervical spine
The cervical spine refers to the seven spinal bones (vertebrae) in the neck. It supports the head and connects to the thoracic spine. Most of the ability to turn the head comes from the top two segments of the cervical spine.
What is a concern while caring for the patient who is completely immobilized to a long backboard?
Because the backboard is a rigid appliance that does not conform to a patient’s body, patients develop pressure sores as a result of being immobilized on the backboard. In 1987, Linares et al.
How long after immobilization can pressure sores develop?
Findings from the three models indicate that pressure ulcers in subdermal tissues under bony prominences very likely occur between the first hour and 4 to 6 hours after sustained loading.
What is the difference between spinal immobilization and spinal motion restriction?
Spinal motion restriction is defined as attempting to maintain the spine in anatomic alignment and minimizing gross movement irrespective of adjuncts or devices. NREMT’s use of the term, spinal immobilization is defined as the use of adjuncts (i.e cervical collar, long board, etc.)
How would you deal with a combative person while also trying to maintain spinal immobilization?
Avoid arguing with the patient. Simply keep repeating the three magic cues, and carry on with patient care. If head-banging ensues, provide padding around the patient’s head. A blanket or “head bed” will eventually be needed for spinal immobilization anyway.
What is Brown sequard syndrome?
Brown-Sequard syndrome (BSS) is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.