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Spinal Immobilization

Spinal Immobilization. Tricks of the Trade. Objectives. Statistics Anatomy review Mechanism of injury Purpose Available equipment Techniques. Statistics. 11,000 spinal cord injuries/year 55% of injuries are 16-30 years old Average age is 32 82% are male 51.6%>tetraplegia

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Spinal Immobilization

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  1. Spinal Immobilization Tricks of the Trade

  2. Objectives • Statistics • Anatomy review • Mechanism of injury • Purpose • Available equipment • Techniques

  3. Statistics • 11,000 spinal cord injuries/year • 55% of injuries are 16-30 years old • Average age is 32 • 82% are male • 51.6%>tetraplegia • 46.3%>paraplegia

  4. Cord Anatomy • Largest nerve • Base of brain to L-2 • Level of cord injury will determine • Pt. outcome • Physical response • Signs & Symptoms • D-2

  5. Effects on breathing • “C3,4,5 keep the diaphram alive” • Phrenic nerve innervates the diaphram • Look for diaphragmatic breathing pattern • Most air movement is accomplished with chest expansion, not pulling of diaphram

  6. Trivia • The praying mantis

  7. Spinal Shock (Neurogenic) • Normal sympathetic stimulation • Heart rate • Blood pressure • vasoconstriction

  8. Spinal Shock (Neurogenic) • Hypovolemia from trauma • Tachycardia • hypotensive • High cervical cord injury • Bradycardic • Hypotensive • Narrowing pulse pressure

  9. Neuro assessment • Know what the patients neuro status is prior to packaging • Movement • Sensation • Strength • Compare after extrication

  10. Mechanism of Injury

  11. Bullet

  12. Permanent damage?

  13. The perfect package job • It doesn’t matter how nice he is packaged when he arrives at the ER • What is important is how he got there • Sandbags, towels, blankets, etc.?

  14. Can you think outside the box when it is necessary? Do you have enough KED’s, collars, backboards or straps?

  15. What is the goal anyway? • Minimize further movement during packaging and transport • Improvise when necessary • Be creative • Minimize neurological effects • Long term effects • A little bit means a lot (Sally)

  16. Devices Available

  17. The Great Helmet Debate • Football • Helmet/pad go together • Critical airway? • Chest trauma?

  18. The Great Helmet Debate • Motorcycle helmets • Usually a good fit • No pads to keep pt. inline • Should be removed or padded under shoulders

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