Protocol Directed Torture: Unnecessary Spinal Immobilization
Day in and day out, EMS providers secure people to hard plastic boards based upon little more than mechanism of injury, or simply to satisfy medical protocol requirements. This presentation will examine the practice of needless spinal immobilization, discuss appropriate assessment steps for determining the need for spinal motion restriction, and discuss the potential for harmful neurological and musculoskeletal sequelae resulting from needless spinal immobilization.
Objectives:
- Discuss the practice and inherent inaccuracy of spinal immobilization based solely upon mechanism of injury.
- Discuss and describe potential clinical findings in patients with unstable cervical spine fractures.
- Discuss potentially harmful side effects of unnecessary spinal immobilization.
- Compare and contrast the accuracy of physical exam (NEXUS criteria) versus cervical spine radiography in identifying and ruling out cervical spine fractures.
- Discuss and describe appropriate cervical spine clearance algorithms and their use.