Spinal Immobilization in Trauma Patients – The Facts

  • There is no high-level evidence that prehospital spinal immobilization positively impacts patient-oriented outcomes
    • Spinal Immobilization Does NOT Help Immobilize the Cervical Spine
    • Spinal Immobilization Does NOT Decrease Rates of Spinal Cord Injury
    • Spinal Immobilization Increases the Difficulty of Airway Management
    • Spinal Immobilization Can Cause Pressure Ulcers
    • Spinal Immobilization Changes the Physical Exam
    • Spinal Immobilization Worsens Pulmonary Function
    • Spinal Immobilization Increases Intracranial Pressure
  • There is no evidence that immobilizing awake, alert patients without deficits/complaints provides benefit
  • Selective spinal immobilization protocols can help identify patients at low risk for injury and avoid immobilization

 

Goodbye C-Collar

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Published reports of early secondary neurologic deterioration after blunt spinal trauma are exceptionally rare and generally poorly documented. High-risk features may include altered mental status and ankylosing spondylitis. It is unclear how often events are linked with spontaneous patient movement and whether such events are preventable.

EMS: C-Collars…time to dump them!

dustbin

Conclusions These data support the findings of the proof of concept study, for haemodynamically stable patients controlled self-extrication causes less movement of the cervical spine than extrications performed using traditional prehospital rescue equipment.

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APLS like everyone else has finally gotten rid of the cervical collar…have you?

MILS

“Consider protecting the cervical spine if the mechanism of injury suggests the possibility of a cervical spine injury. If protection is considered necessary, start with manual in-line stabilisation (MILS) by a competent assistant or if this is not possible, consider using head block and appropriate strapping”