Sign up to save your podcasts
Or
Share EMS A to Z: Spinal Motion Restriction
Share to email
Share to Facebook
Share to X
Share to email
Share to Facebook
Share to X
Or
EMS A to Z: Spinal Motion Restriction
EMS A to Z: Spinal Motion Restriction
Show Notes:
From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn
Today we are going to discuss the indications for and techniques used in spinal motion restriction. Let’s start by defining SMR, what does that actually mean?
SMR refers to stabilizing and restricting movement of the spine with the goal to prevent worsening of any possible fractures, ligamentous injuries, or spinal cord injuries.
When is SMR indicated?
In blunt trauma patients with any of the following high-risk features:
Any altered mental status (GCS 65
Axial load injuries (diving injuries, spearing tackle), sudden acceleration/deceleration, lateral bending forces to neck/torso.
Remind us what the field trauma triage criteria are?
http://saemscouncil.com/wp-content/uploads/2020/06/Trauma-Triage_6.16.20.pdf
So, if the patient meets NONE of those criteria AND meets the Low Risk criteria, they can be transported without immobilization...
Minor mechanism - equivalent to simple rear end collision
No neck pain on scene
No midline cervical tenderness
Ambulatory on scene at any time
Does SMR require the use of a backboard?
No; backboards should ideally be used for extrication only.
Can patients with isolated suspected cervical spinal injury be transported seated?
Patients should be transported flat, if possible, but slight elevation of the head of the gurney can be accommodated. Sitting fully upright is not recommended.
Remember to take care when moving the patient who requires spinal motion restriction, as any patient movement creates risk for spinal injury.
Is spinal motion restriction indicated in penetrating trauma?
Not usually, however if there is concern for spinal injury or neurologic deficit present, it may be indicated.
For additional reference, see the position statement released by NAEMSP.
https://naemsp.org/home/news/spinal-motion-restriction-in-the-trauma-patient-%E2%80%93/#:~:text=The%20goal%20of%20both%20SMR,of%20the%20potentially%20injured%20spine.&text=Indications%20for%20SMR%20following%20blunt,back%20pain%20and%2For%20tenderness
View all episodes
By EMSAtoZ
5
55 ratings
EMS A to Z: Spinal Motion Restriction
Show Notes:
From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn
Today we are going to discuss the indications for and techniques used in spinal motion restriction. Let’s start by defining SMR, what does that actually mean?
SMR refers to stabilizing and restricting movement of the spine with the goal to prevent worsening of any possible fractures, ligamentous injuries, or spinal cord injuries.
When is SMR indicated?
In blunt trauma patients with any of the following high-risk features:
Any altered mental status (GCS 65
Axial load injuries (diving injuries, spearing tackle), sudden acceleration/deceleration, lateral bending forces to neck/torso.
Remind us what the field trauma triage criteria are?
http://saemscouncil.com/wp-content/uploads/2020/06/Trauma-Triage_6.16.20.pdf
So, if the patient meets NONE of those criteria AND meets the Low Risk criteria, they can be transported without immobilization...
Minor mechanism - equivalent to simple rear end collision
No neck pain on scene
No midline cervical tenderness
Ambulatory on scene at any time
Does SMR require the use of a backboard?
No; backboards should ideally be used for extrication only.
Can patients with isolated suspected cervical spinal injury be transported seated?
Patients should be transported flat, if possible, but slight elevation of the head of the gurney can be accommodated. Sitting fully upright is not recommended.
Remember to take care when moving the patient who requires spinal motion restriction, as any patient movement creates risk for spinal injury.
Is spinal motion restriction indicated in penetrating trauma?
Not usually, however if there is concern for spinal injury or neurologic deficit present, it may be indicated.
For additional reference, see the position statement released by NAEMSP.
https://naemsp.org/home/news/spinal-motion-restriction-in-the-trauma-patient-%E2%80%93/#:~:text=The%20goal%20of%20both%20SMR,of%20the%20potentially%20injured%20spine.&text=Indications%20for%20SMR%20following%20blunt,back%20pain%20and%2For%20tenderness