Memo - Clarification on Selection for Spinal Immobilization

Clarification on Selection for Spinal Immobilization

2009-04-30

Our practice parameters and our teachings attempt to assist paramedics not in “spinal clearance” but in “who should be selected for spinal immobilization”.

The factors on making the decision to utilize spinal immobilization are:

• Mechanism
• Affected body part
• Complaint of pain
• Tenderness on palpation
• Pain with movement back to neutral
• Ability to lay flat without pain
• Worsening breathing with supination
• Among others . . . .

The over arching criteria is . . . anyone that may need a “C” collar and can tolerate it, should have one. And . . . anyone who may have a spinal injury and can tolerate a backboard should be placed on one.

Obviously, those that cannot tolerate these forms of treatment should still be protected against overt movement.

Please do not use the phrase “spinal clearance” in discussions with hospital or in your documentation. Spinal clearance is done in the ER.