Protocol 40 Spinal Motion Restriction 05/02/2016

Questions and Answers

Which condition does NOT warrant spinal motion restriction?

Patient with evidence of altered mental status

Patient experiencing pain on movement of the neck

Patient presenting with paralysis in the legs

Patient showing normal neurological function in all extremities (correct)

What is a necessary indication for spinal motion restriction?

Patient is calm and cooperative

Stable patient with normal vital signs

Patient denies having any spinal pain

Pain on movement of the neck or back (correct)

Which of the following factors is NOT considered when determining spinal motion restriction?

Patient's age being less than 9 years

Presence of acute stress reaction

Patient's cooperation during assessment (correct)

Level of communication barriers

What should be done if a patient meets none of the spinal motion restriction exclusion criteria?

Place the patient on a backboard with full spinal motion restriction Signup and view all the answers

Which characteristic of a patient indicates they should not undergo spinal motion restriction?

Full range of motion of both upper limbs without pain Signup and view all the answers

What immediate action should be taken when a patient shows signs of unconsciousness with suspected trauma?

Implement full spinal motion restriction Signup and view all the answers

Under which situation is spinal motion restriction excluded despite potential spinal injury?

Patient is calm and cooperative with no language barriers Signup and view all the answers

Which of the following does NOT indicate a need for spinal motion restriction?

Normal peripheral perfusion signs Signup and view all the answers

What is the first step in assessing a patient with neck and/or back pain after a traumatic incident?

Initiate manual in-line stabilization of the head Signup and view all the answers

Which statement is true regarding the application of a vest-type extrication device (KED)?

Groin loops should be connected before torso straps are fastened Signup and view all the answers

When is spinal motion restriction indicated?

The patient has altered mental status with suspected spinal injury Signup and view all the answers

What position should the head be in during manual stabilization?

Neutral in-line position Signup and view all the answers

What should be done after inserting the KED behind the patient?

Ensure the device is securely positioned under the axilla Signup and view all the answers

What is the appropriate action if a patient shows signs of drug intoxication with a suspected spinal injury?

Perform spinal motion restriction Signup and view all the answers

Which of the following movements should be avoided when positioning a KED?

All of the above Signup and view all the answers

What is a sign that spinal motion restriction is necessary when assessing a patient's neck movements?

Severe neck pain occurs during movement attempts Signup and view all the answers

What is a contraindication for placing a patient in an in-line position during spinal motion restriction?

Increase in neurological deficits Signup and view all the answers

Which of the following is NOT essential equipment for spinal motion restriction?

Oxygen supply Signup and view all the answers

When should manual stabilization of the patient's head be maintained until?

Spinal motion restriction is completed Signup and view all the answers

How should the cervical collar be sized?

By measuring from the jaw to the top of the trapezius Signup and view all the answers

What should NOT be done if an appropriately sized cervical collar is unavailable?

Cease all stabilization efforts Signup and view all the answers

What is the purpose of padding between the head and backboard?

To prevent hyperextension of the cervical vertebrae Signup and view all the answers

How should a pediatric patient's neck be supported to prevent hyperflexion?

By lifting the shoulders with padding Signup and view all the answers

To secure the patient’s body on a backboard, which method is NOT recommended?

Taping the patient’s head directly to the board Signup and view all the answers

Which of the following injuries may indicate a need for a backboard despite clinical judgment?

Long bone fracture Signup and view all the answers

What should be done if a patient exhibits a significant neck muscle spasm?

Avoid placing the patient in an in-line position Signup and view all the answers

What step should follow securing the patient's torso to prevent sliding during transport?

Apply additional circumferential straps Signup and view all the answers

Which factor is considered a high-energy mechanism for evaluating potential spinal injuries?

Motor vehicle collision Signup and view all the answers

What is the primary goal of spinal motion restriction?

To prevent further injury to the spinal cord Signup and view all the answers

Study Notes

Spinal Motion Restriction Overview

Indicated for patients with signs of potential spinal cord injury following trauma.
Assessment mandatory for individuals with neck/back pain or consistent injury mechanisms.

Exclusion Criteria for Spinal Motion Restriction

Stable Patient: Normal peripheral perfusion.
Reliable Patient:
- Aged 9 years or older.
- Calm, cooperative, no altered mental status (e.g., dementia, intoxication).
- No spinal pain or tenderness upon palpation.
- Normal neurological function in all extremities.
If any criteria are not met, patient requires full spinal motion restriction using a backboard.

Inclusion Criteria for Spinal Motion Restriction

Necessary to prevent severe injuries during transport.
Indications include:
- Pain or tenderness upon movement of neck/back.
- Paralysis, numbness, or tingling in extremities.
- Signs of neurogenic shock or unconsciousness.
- Significant injuries above the clavicles or high-energy injury mechanisms, especially if intoxicated.
Clinical judgment can override criteria if spinal cord injury is suspected.

Equipment for Spinal Motion Restriction

Long spine board, cervical collar, padding, blanket roll, straps, and tape required.

Spinal Motion Restriction Procedures

Adult Care - Supine/Prone Patient

Manual stabilization of the head in a neutral position is essential.
Identify contraindications such as neck spasm or airway compromise.
Appropriate cervical collar application is critical.
Log roll patient onto the board, secure with straps, and ensure head immobilization without interfering with airways.

Pediatric Care - Similar to Adult Care

Manual in-line stabilization and assessment needed.
Pediatric-specific padding to prevent neck hyperflexion.
Strapping and securing procedures mimic those of adult care, with additional void space considerations.

Spinal Motion Restriction for Standing Patient

Begin with manual stabilization and cervical collar application.
Slowly lower the board while keeping the patient stable.

Vest-Type Extrication Device (KED) Use

Manual in-line stabilization and cervical collar application crucial.
Insert KED with minimal movement, securing around the torso and head to avoid further injury.

Spinal Injury Assessment Methodology

Must have stable vital signs, be ≥ 9 years, and be cooperative.
Assess for GCS and signs of intoxication.
Palpate along the spine for tenderness or deformity.
Evaluate extremity mobility; restricted or painful movements necessitate spinal motion restriction.

Important Considerations

Maintain careful monitoring of the patient's stability and position to avoid further injury during assessment and transport.
Caution needed with any penetrating injuries affecting airway or ventilation.

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Description

This quiz covers the guidelines for spinal motion restriction and the criteria for determining when it is necessary. It focuses on assessing patients with neck or back pain and the protocols in place for spinal injury evaluation. Test your understanding of these essential safety measures in trauma care.