1-8. Spinal Motion Restriction

Consider immobilizing a patient with a significant mechanism of injury if:

1) GCS < 15?

2) Intoxication: Any evidence of alcohol or drug intoxication?

3) Neuro exam: Any focal motor or sensory deficit? Any transient deficit that has resolved?

4) Distracting injuries: Any painful injury that might distract the patient from the pain of a spinal injury?

5) Exam: Any tenderness or pain over the midline of the cervical spine?

6) Extremes of age: be extra cautious in those patients younger than 5 years or older than 65 years.

Apply a cervical collar and perform SMR as below:

1) Spinal motion restriction should be considered for any patient who has been subjected to mechanisms of injury that have a high index of suspicion for cervical, thoracic, lumbar or spinal cord injury.

2) Firmly secure the torso to EMS stretcher or conforming device (e.g., vacuum splint).

3) Use of a hard surface backboard should be avoided, but may be considered for cases in which:

a) The backboard is used for extrication from a scene / vehicle, but it should be removed after the patient is placed on the EMS stretcher.

b) Removal of the backboard would delay the transport of a critical patient.

c) The backboard is needed for CPR chest compressions.