“Absence of clinical findings reliably excludes unstable cervical spine injuries in children 5 years or younger…DON’T X-RAY”
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
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!
APLS like everyone else has finally gotten rid of the cervical collar…have you?
“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”