C-Spine precautions for penetrating trauma.

[hippocratical]

I remember years ago (when I was working as a psychologist in Australia) that a year-long study in Thailand had found no significant difference between their old and new styles of patient transfer in regards to C-spine issues:

OLD STYLE: Pick up mangled tuk tuk driver and physically throw them in the back of a small minivan (this isn't even an exaggeration, I mean literally)

NEW STYLE: Back boards, C-spine immobilization etc

# of paralyzed pts? Same. This is probably old news to many of you.

Is "C-Spine motion restriction" a good idea? Sure I'd probably prefer it if it was Me all mangled, just in case. Does it affect the outcome in more than 1:10,000 cases? I'd be surprised.

Am I mad or is this the consensus?

 

[LondonMedic]

Am I mad or is this the consensus?

I think that it's fair to say that that is the upshot of a lot of the evidence.

C-spine immobilisation probably does benefit a small cohort of trauma patients and the earlier that cohort (or rather those that aren't at risk) are identified the better.

The trick is going to be defining a specicific examination which is sensitive enough. Until the we are left with NEXUS or Canadian both of which are very sensitive but poorly specific, and we can't even apply those well universally.