Learn about the spinal assessment and spine stabilization methods. The spinal assessment is part of the secondary examination. It is up to you whether it is necessary to perform one. If you suspect a spinal injury, e.g., the patient had a large fall, and the situation allows, you can perform a spinal test. Doing so can help you determine whether you need to stabilize the person’s spine before moving him.
The information in this post is from the book “Wilderness and Travel Medicine” by Sam Fury.
Wilderness and Travel Medicine is a comprehensive handbook with a minimalist approach. It contains prevention, diagnoses, and treatments for a wide range of ailments using modern and “survival” medicines.
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Spinal Assessment and Spine Stabilization
IMPORTANT: No amount of reading can compare to a medical course with a professional trainer. A standard first aid course is good. A Remote Area First Aid Course or higher is best.
To rule out a spinal injury the patient should meet the following criteria:
- Reliable. Cooperative, sober, alert, and free of distracting injuries.
- No spinal pain.
- No spinal tenderness. Using slight pressure, press down the patients back to the sides of the vertebrae. Never press directly on the vertebrae.
- Normal motor/sensory function in all four extremities. Do this during the extremities test in the physical exam. This does not apply if the extremity has a specific injury that would affect the outcome, e.g., broken wrist.
- No numbness or tingling.
If the patient fails the spinal test, you must stabilize the spine.
Note: A collar alone does not stabilize the spine.
Keep the neck and back as stable as possible.
Consider stabilizing the patient’s spine while he is on his side. This is especially true if the patient is already like that, or if you have to leave him.
Aligning the Body
Before you stabilize the spine, the body needs to be in its correct anatomic position. This position is with the patient lying down with his legs together and arms down his sides. It is best if the patient is on his back.
- Be very careful.
- Move only one body part at a time.
- Undo kinks.
- Straighten joints.
- Move arms and legs close to the body.
- Stop if you meet increased pain or resistance.
If moving the patient it is preferable to secure him to a rigid litter.
A rolled up blanket or a sleeping mat are a couple of ways you can improvise head stabilization. A stuff-sack filled with sand (or whatever) is also good to use.
Photo Credit: Kevin Gaddie
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