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Spinal Immobilization

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by

Monata Song

on 13 January 2014

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Transcript of Spinal Immobilization

Spinal Immobilization
By Monata Song

What is it? Why is it so important?
Spinal Immobilization:

the procedure where EMT's prevent all parts of the spine and neck from moving during treatment and/or transport

Spinal Immobilization is important and necessary in order to avoid any movement of the spine which may cause further damage or possible paralysis to the patient.
Spine and Neck Anatomy
Parts of the Spine and Neck:
Cervical (neck)
7 vertebrae
Thoracic (thorax, ribs, upper back)
12 vertebrae
Lumbar (lower back)
5 vertebrae
Sacral (back wall of pelvis)
5 vertebrae
Coccyx (tailbone)
4 vertebrae
When is Spine Immobilization Used?
EMT's must know when a patient needs spine immobilization.

Spine is most often injured by compression,
excessive flexion, extension, or rotation from falls,
diving, motor-vehicle accidents.
Spine injuried by EMS by improper and incorrect
lifting techniques causing lateral bending/disc
injuries.

**Rule of Thumb**
If the MOI exerts great force on the upper body/ if there is soft tissue damage to the head, face, neck due to trauma, assume possible cervical-spine injury.
Common Signs and Symptoms of spine injury
Paralysis of extremities (
most reliable sign)
Pain without movement
Pain with movement
Tenderness anywhere along the spine
Impaired breathing
Deformities Priapism
(persistent erection of penis)
Loss of bowel or bladder control
Nerve impairment to the extremities
Neurogenic shock
Soft tissue injuries associated with trauma
General Patient Care for Spinal Injury
1. Provide manual in-line stabilization
(C-spine) until properly secured to
backboard.
2. Assess the patient's ABC's
3. Assess head/neck and apply rigid
cervical collar
4. Assess S&M's in all four extremities
5. Apply appropriate spinal
immobilization device
6. Administer oxygen via nonrebreather
mask if patient has paralysis weakness in extremities
7. Reassess S&M's
Applying Cervical Collar
Collars are designes to limit flexation, extension, and lateral movement when combined with immobilization devices *such as a long backboard or vest-style device
stabilize head/neck using c-spine
measure height of collar with fingers and adjust accordingly
position collar and completely secure collar so movement is minimal/non existant
For supine patient, feed one end of collar under the curve of the neck and secure collar around neck area
Maintain c-spine
KED on seated patient
Long Backboarding on Standing/LyingDown Patient
Normal extrication technique
1. Stabilize head w/ c-spine
2. primary assessment
3. rapid trauma assessment
4. Rigid/cervical collar
5. secure patient to KED
A KEDa vest-style extrication device.
A flexible piece of equipment useful for immobilizing patients in a confined space
When applying KED:
1. Position device behind patient
2. Secure the torso FIRST
3. See if patient needs padding behind head then secure the head
4. evaluate and adjust straps to allow adequate breathing and circulation
5. Reassess CSMs
1. Stabilize the head and neck/ apply collar
2. Place board parallel to patient
3. Have 3 people roll patient towards them while one person maintains c-spine and directs others.
4. One EMT grabs board and pulls it against patient
5. Roll patient onto board and position patient correctly.
6. Strap patient starting with hips, chest, legs, head
**TIPS**
Placing pads between patient's head and torso minimizes movement
Do NOT release c-spine until patient is fully and completely strapped in
If patient is standing use rapid takedown
Maine EMS Spine Assessment Protocol
Mechanism of Injury: Axial load (diving), blunt truma, MVC or bicycle, fall>3ft, adult fall from standing height
Unreliable
(intox, alt LOC/ acute stress reaction
Distracting injury
Abnormal Sensory/Motor Exam
Spine Pain/ Tenderness?
Don't Immobilize
IMMOBILIZE
Full transcript