Let me float some ideas about "clearing C spine"
..or any spine for that matter.
1. "Spinal injury" is both ortho AND neuro, does not always show on simple xray except for fractures, and sometimes not easy to see minor ones that go back into place). Injury can be to the nerves and other soft tissue alone, or at least the boney materials all reassume their proper placement.
2. Spinal immobilization was adopted and pounced upon because the MVA victim in the 1950-60's era autos (no restraints, hard dashboards, no headrests, no airbags, room to accelerate before your legs or torso or head hit anything, hard steering columns, etc) who survived the initial collision and mechanical sequelae was most likely to have experienced fractures including the face and neck and the rest of the spine.
3. Strict spinal immobilization does not address soft tissue injury per se, is frequently refused or fought, uncomfortable, and has acheived mythic status when all it is, is splinting.
I feel field clearance allows some cases to go without potentially beneficial precautions unless the practitioners and the protocols are really on top of neuro evals adapted specifically to rule out neuro injury, or even the ortho-muscular insults most likely to result in neuro compromise. (And remember, neuro insult symptoms can sometimes be seen later once swelling has set in). Maybe we need a national change in protocols and even tools? Or does careful application of current art allow for sufficient treatment and avoidance of iatrogenic transport injuries?
