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Spinal Motion Restriction- Assessment

based on ACS/ACEP/NAEMSP position statement 2018*



Blunt Trauma Penetrating Trauma

Altered Mental Status Spinal Motion


or
intoxication present?
Restriction

Mark L. Gestring (2018) Spinal Motion Restriction in the Trauma Patient – A Joint Position Statement, Prehospital Emergency


* Peter E. Fischer, Debra G. Perina, Theodore R. Delbridge, Mary E. Fallat, Jeffrey P. Salomone, Jimm Dodd, Eileen M. Bulger &
not indicated

YES NO

Midline neck or back pain


and/or tenderness?

Perform YES NO
Spinal Motion

Care, DOI: 10.1080/10903127.2018.1481476
Restriction Focal neurologic signs
and/or symptoms?
Includes cervical collar
and acceptable devices.
Not necessarily a YES NO
backboard

Acceptable Devices Anatomic deformity


of the spine?
Ambulance stretcher
Vacuum mattress
Scoop Stretcher YES NO
Long Spine Board

Distracting injury or
circumstance?

YES NO

Spinal Motion
Restriction
not necessary
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Spinal Motion Restriction- Application
based on ACS/ACEP/NAEMSP position statement 2018*

Spinal Motion Restriction is Indicated

Direct patient to limit spine


movement

Apply cervical collar

Patient Position
Always follow local protocols

STANDING SEATED SUPINE


(automobile)

Guide patient to Guide and lower Assemble scoop


carefully sit then patient to long stretcher under
recline on spine board patient
ambulance
stretcher
Long Short Move patient to
transport transport ambulance
stretcher and
remove scoop

Remove patient from


Patient may remain
board with minimal
on board
spinal movement

Secure patient to stretcher

Transport

When Choosing Devices and Transportation Methods Consider:

POSITIONING LONG TRANSPORT SHORT TRANSPORT


Bariatric Use a more comfortable device May keep patient on device
Respiratory Distress or remove patient from or use a more comfortable
Pregnancy device and use stretcher as SMR device (vacuum mattress)

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