Rigid spinal immobilization is not without risk to the patient. It has been shown to decrease forced vital capacity in both the adult and pediatric populations,2 compromise vascular function and increase risk of pressure ulcers,3-4 and can confound emergency department assessment of traumatic injuries by causing pain.
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 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.
Why is spinal motion restriction important?
For this reason, the term “spinal motion restriction (SMR)” has gained favor over “spinal immobilization,” although both terms refer to the same concept. The goal of both SMR and spinal immobilization in the trauma patient is to minimize unwanted movement of the potentially injured spine.
How do you use spinal immobilization?
How to Implement Spinal Motion Immobilization
- Grasp the patient’s head and shoulders from a position at the head of the bed, physically keeping the spine aligned with the head.
- While maintaining spinal alignment, have an assistant apply a cervical collar without lifting the head off the bed.
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.
Which portions of the spine are the most vulnerable to injury?
The majority of fractures and dislocations of the spinal column occur in the cervical spine because it is the most mobile portion of the spinal column, and understandably, the most vulnerable to injury.
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.)
Which of the following is the most common mechanism for spinal trauma?
Among patients below 2 years with spinal trauma, NAT was tied as the most common mechanism, resulting in 38% of injuries. Eight of the 11 patients’ spine injuries were cervical and 7 of these injuries were in the atlanto-occipital and atlantoaxial regions. Multilevel spine trauma was present in 64% of patients.
What is the age range for spinal motion restriction?
NEXUS criteria applies to spinal injuries above the clavicles for patients ages 16-65. For patients > 65 years of age, minor mechanisms (fall from a standing height) can result in major spinal injuries and requires SMR.
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 …