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Spinal Immobilization

This comprehensive guide delves into spinal immobilization strategies essential for emergency responders. It covers key topics including spinal cord injury statistics, anatomy, mechanisms of injury, and vital techniques for minimizing movement during transport. Learn the importance of understanding neuro status prior to packaging, and how to effectively use available equipment like KEDs and backboards. With a focus on creative problem-solving and the critical care of spinal injuries, this resource is vital for ensuring optimal patient outcomes.

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Spinal Immobilization

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Presentation Transcript

  1. Spinal Immobilization Tricks of the Trade

  2. Objectives • Statistics • Anatomy review • Mechanism of injury • Purpose • Available equipment • Techniques

  3. Statistics • 11,000 spinal cord injuries/year • 55% of injuries are 16-30 years old • Average age is 32 • 82% are male • 51.6%>tetraplegia • 46.3%>paraplegia

  4. Cord Anatomy • Largest nerve • Base of brain to L-2 • Level of cord injury will determine • Pt. outcome • Physical response • Signs & Symptoms • D-2

  5. Effects on breathing • “C3,4,5 keep the diaphram alive” • Phrenic nerve innervates the diaphram • Look for diaphragmatic breathing pattern • Most air movement is accomplished with chest expansion, not pulling of diaphram

  6. Trivia • The praying mantis

  7. Spinal Shock (Neurogenic) • Normal sympathetic stimulation • Heart rate • Blood pressure • vasoconstriction

  8. Spinal Shock (Neurogenic) • Hypovolemia from trauma • Tachycardia • hypotensive • High cervical cord injury • Bradycardic • Hypotensive • Narrowing pulse pressure

  9. Neuro assessment • Know what the patients neuro status is prior to packaging • Movement • Sensation • Strength • Compare after extrication

  10. Mechanism of Injury

  11. Bullet

  12. Permanent damage?

  13. The perfect package job • It doesn’t matter how nice he is packaged when he arrives at the ER • What is important is how he got there • Sandbags, towels, blankets, etc.?

  14. Can you think outside the box when it is necessary? Do you have enough KED’s, collars, backboards or straps?

  15. What is the goal anyway? • Minimize further movement during packaging and transport • Improvise when necessary • Be creative • Minimize neurological effects • Long term effects • A little bit means a lot (Sally)

  16. Devices Available

  17. The Great Helmet Debate • Football • Helmet/pad go together • Critical airway? • Chest trauma?

  18. The Great Helmet Debate • Motorcycle helmets • Usually a good fit • No pads to keep pt. inline • Should be removed or padded under shoulders

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