SPINAL IMMOBILIZATION

HIGH DESERT STATE PRISON

MEDICAL EDUCATION

Course Objectives

• Title: Cervical Spine Immobilization

• Instructor requirements: Subject matter expertise.

• Target audience: CDCR Medical personnel.

• Format: Classroom lecture and competency demonstration or self-study review.

• References: NorCal EMS policy and procedure, IMSP policy and procedure, Volume 4, Chpt 12 & 13, Title 22.

• At the end of this lesson the student will:

• Demonstrate the proper steps and technique for applying Cervical Spine Immobilization.

• Demonstrate knowledge of when to place a patient in basic C-spine immobilization as described in the included algorithm.

• Satisfactorily complete the competency validation demonstration.

• Complete the written post test with a score of 84% or better.

Northern California EMSPolicy and Procedure – Health and Safety

Code – Div. 2.5 - Sec.1797.220

• Policy: “If there is any reasonable possibility that a patient may have suffered a spinal injury, then the spine must be properly immobilized. Consider immobilization in a patient who sustains trauma that has any possibility of injury to the cervical spine.”

• Full Spinal Precautions - Definition:

“These include backboard, straps capable of securing the body properly, padding and head immobilization device, which includes some type of mechanism to properly secure the head to the board.”

SPINAL IMMOBILIZAITON

• Provide spinal immobilization if any of the following inclusion criteria apply:

• Victim of high speed accident (>40mph).

• Falls greater than 20 feet.• Any gunshot or stab wound to the

spine.• Suspicion of alcohol and/or drug

abuse.• Neck or back pain on patient

movement.• Neck or back tenderness on

palpation• Neurological deficits or

deformity.• Other painful or

distracting injuries.• Language barrier.

• Difficult to evaluate due to age or mental status.

• Not alert, disoriented or GCS <15.• Abnormal vital signs.• Loss of consciousness.

• Document your findings on the First Responder Data Collection Tool, the ER Flow Sheet, or a Progress Note – (in addition to the 7219).

• BE A PATIENT ADVOCATE – if you suspect the possibility of a spinal or head Injury you should always immobilize!

Nor-Cal EMSSpinal

ImmobilizationAlgorithm

Nor-Cal EMSSpinal

ImmobilizationAlgorithm

From Nor-Cal EMS PolicyFrom Nor-Cal EMS Policy

From NorCal EMS PolicyFrom NorCal EMS Policy

Step One: Manually Stabilize

the cervical Spine – “Marry the Head”

Step One: Manually Stabilize

the cervical Spine – “Marry the Head”

Maintain good spinal alignment throughout the entire process.Do not stop until the patient is completely secured to the backboard

Maintain good spinal alignment throughout the entire process.Do not stop until the patient is completely secured to the backboard

Step Two: Logrolling the supine patientStep Two: Logrolling the supine patient

Work as a team, follow one leaders commands and maintain good spinal alignment.

Work as a team, follow one leaders commands and maintain good spinal alignment.

“On MyCount –

One, Two,

Three..”

Head of backboard Make sure

There is room to placethe head blocks at the top

of the board

Head of backboard Make sure

There is room to placethe head blocks at the top

of the board

Foot of backboardFoot of backboard

Roll the patient on side andplace backboard.

Roll the patient on side andplace backboard.

Maintain good spinal alignment throughoutMaintain good spinal alignment throughout

Gently lower the Patient and the backboard

to the ground

Gently lower the Patient and the backboard

to the ground

Full C-SpineImmobilization

StandingPatient

Full C-SpineImmobilization

StandingPatient

Most of the body weight is

between theshoulders and the

upper thighs, placethe straps accordingly

Most of the body weight is

between theshoulders and the

upper thighs, placethe straps accordingly

Use tape to secure the foreheadAnd the chin area to the backboard

Use tape to secure the foreheadAnd the chin area to the backboard

Get plenty of help andlift patient using good

body mechanics

Get plenty of help andlift patient using good

body mechanics

NowWhat?

NowWhat?

Spinal Immobilization QuizName__________________ Date__________

1. Every emergency responder must carry a C-collar, T or F?_________.2. Proper cervical spine immobilization includes use of a C-collar and a back board, T or F?

__________.3. If you are unable to determine what happened to a patient because of a language barrier

and you suspect a possible neck or head injury, you must provide C-spine immobilization, T or F?__________.

4. If an inmate/patient’s breath smells of alcohol and a drug kit is found in the cell and you suspect a possible neck or head injury, you do not need to provide C-spine immobilization, T or F?____________.

5. You must observe at least two or more of the inclusion criteria before attempting C-spine immobilization, T or F?________.

6. You must provide C-spine immobilization if there is any reasonable possibility that a patient may have suffered a spinal or head injury, T or F?____________.

7. If a inmate/patient is found sitting quietly in his cell, has no back/neck pain, is not intoxicated, is alert and oriented x3, has no mental status changes, neuro deficits, or distracting injuries; you do not have to apply C-spine immobilization, T or F?_____________.

8. It is possible that a neck or head injury can go unnoticed until later? T or F?______.9. A patient has the right to refuse C-Spine Immobilization. T or F?_______.