San Andreas Fire Rescue
Department of Forestry & Fire Protection
Spinal Injury (CPG A0804)
Assessment
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Major trauma criteria after blunt force trauma to head or trunk
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Neurological deficit/changes
Action - Suspected SCI or major trauma
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Apply cervical collar
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Extricate and immobilise
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Tx as per CPG A0105
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If isolated SCI with BP < 90 mmHg:
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N/Saline 10 mL/kg IV
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Assessment - TPT
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If any of the following are present:
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Age ≥ 65 years
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Hx of bone or muscle weakening disease/injury
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Altered conscious state
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Intoxication
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Significant distracting injury
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Midline pain/tenderness
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Pt unable to rotate neck 45° left and right without pain
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Mx as per suspected SCI or major trauma
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Consider self-extrication if Pt is conscious, cooperative, not intoxicated and not prevented by other injuries
Action - Cervical spine cleared
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No spinal immobilisation required
Notes
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The intent of immobilisation is to support neutral alignment of the spinal column. Techniques employed should be modified if required by circumstances or for Pt comfort/cooperation
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The Pts head must not be independently restrained to the stretcher
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The Pt should not be transported on the CombiCarrier
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Frail/elderly Pts, or those with pre-existing bone disease or spinal abnormalities may sustain unstable injuries with relatively low forces
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Pts with penetrating trauma do not require routine immobilisation in the absence of neurological deficits
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In immobilised awake Pts, consider prophylactic anti-emetics as per CPG A0701
Spinal Injury - Neurological Exam
Flow Chart