Bye bye everyday c-spine

[Jakeyjake]

Awesome.. I wish this would spread to CT. I was at a trauma conference that said c-spine immobilization has very little evidence behind it and only a tiny, tiny portion of MVAs even cause cspine fractures.

 

[Christopher]

North Carolina uses the Canadian C-Spine rule for "clearing" and just added the following notes to the Statewide Selective Spinal Immobilization protocol:

Patients meeting all the above criteria may be “cleared” from spinal immobilization. However, patients who fail one or more criteria above require spinal stabilization but do NOT always require use of the long spine board (see below.)

Immobilization on a long spine board is not necessary where:

• Patient has normal LOC with no spine tenderness / deformity, no neurological signs / symptoms, no distracting injury, no intoxication with drugs and / or alcohol.
• Penetrating trauma to the head, neck or torso with no signs / symptoms of spinal injury.

Immobilization May be maintained by cervical collar and securing to EMS stretcher ONLY where:

• Patients are found to be ambulatory at the scene.
• Transport for a protracted time (> 45 minutes) or during an inter-facility transfer.
• Patients where a long spine board is not otherwise indicated.

When long spine board not utilized spinal precautions in at-risk patients is paramount. These include:

• cervical collar
• securing to stretcher
• minimal movement / transfers and maintenance of in-line spine stabilization during any necessary movement / transfers.

This includes the elderly or others with body or spine habitus preventing them from lying flat.

 

[fngemt]

Finally

 

[Gymratt]

We got away from spinal packaging every single patient several years ago. Statewide protocols set the guidelines to which we use to determine if they need packaging or not.