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    De Lorenzo, Robert A. 1996. A review of spinal immobilization techniques. The Journal of Emergency Medicine, Vol. 14, Issue. 5, p. 603.
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Clinical Guidelines for Delayed or Prolonged Transport*: III. Spine Injury

  • Rural Affairs Committee and National Association of Emergency Medical Services Physicians
Extract

Conventional emergency medical services (EMS) guidelines recommend that essentially every victim of any significant trauma be treated in the field as having an unstable spine injury. For example, any victim of any motor vehicle crash generally is assumed to have an unstable spine injury and is transported to the hospital in full-spine immobilization. This approach generally is reasonable and appropriate for the conventional EMS context of rapid transport, because patient symptoms and physical examination often are unreliable for the time period immediately following the event.

The specialized context of delayed or prolonged transport, however, requires a closer look at assessment criteria and treatment procedures for spine injury. Full-spine immobilization, if it is not required, can be unnecessarily difficult, impractical, impossible, and even dangerous during prolonged evacuation, especially in severe environments or when using improvized equipment. Prolonged transport also provides an opportunity to repeat patient surveys and to observe changes in the patient's condition over time.

Copyright
COPYRIGHT: © World Association for Disaster and Emergency Medicine 1993
Corresponding author
Kathleen Stage-Kern, Executive Director, National Association of EMS Physicians, Executive and National Resource Center, 230 McKee Place, Suite 500, Pittsburgh, PA 15213 USA
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*

This is a corrected version of the We Believe that was published in Vol.8, No. 2 of Prehospilal and Disaster Medicine. Definition number 4 has been corrected. We apologize for this error.

Footnotes
References
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Bachulis, BL, Long, WB, Hynes, GD et al. : Clinical indications for cervical spine radiographs in the traumatized patient. Ann Surgery 1987;153:473–477.
Bressler, MJ, Rich, GH: Occult cervical spine fracture in an ambulatory patient. Ann Emerg Med 1982;11:440–442.
Burgess, AR, Poka, A: Musculoskeletal trauma. Emerg Med Clin N Amer 1984;2:871–882.
Cadoux, CG, White, JD, Hedberg, MC: High- yield roentgenographic criteria for cervical spine injuries. Ann Emerg Med 1987;16:738–742.
Chilton, J, Dagi, TF: Acute cervical spine injuries. Am J Emerg Med 1985;3:340–351.
Dagi, TF: The exclusion of cervical spine injury. Am J Emerg Med 1988;6:312–313. Editorial
Deutsch, DS: The evaluation and immediate care of the patient with spinal trauma. RI Med J 1980;63:265–269.
Fischer, RF: Cervical radiographic evaluation of alert patients following blunt trauma. Ann Emerg Med 1984;13:905–907.
Herkowitz, HN, Roth man, RH: Subacute instability of the cervical spine. Spine 1986;9:348–357.
Holdsworth, F: Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg 1970;52A:1534–1551.
Jaffe, DM, Binns, H, Redkowski, MA et al. : Developing a clinical algorithm for early management of cervical spine injury in child trauma victims. Ann Emerg Med 1987;16:270–276.
Kaplan, D: Spine problems in emergency department patients: Does every patient need an X-ray? J Emerg Med 1985;2:257–263.
Kassel, EE, Cooper, PW, Rubenstein, JD: Radiology of spinal trauma—practical experience in a trauma unit. J Can Assoc Radial 1983;34:189–203.
Knopp, RK: Evaluation of the cervical spine: Unresolved issues. Ann Emerg Med 1987;16:1–27. Editorial.
Korres, DS, Katsaros, A, Pantazopoulos, T et al. : Double or multiple level fractures of the spine. Injury 1981;13:147–152.
Lee, C, Rogers, LF, Woodring, JH et al. : Fractures of the craniovertebral junction associated with other fractures of the spine: Overlooked entity? AJNR 1984;5:775–781.
McArdle, CB, Wright, JW, Prevost, WJ et al. : MR imaging of the acutely injured patient with cervical traction. Radiology 1986;159:273–274.
Mace, SE: Emergency evaluation of cervical spine injuries: CT versus plain radiographs. Ann Emerg Med 1985;14:973–975.
Miller, MD, Gehweiler, JA, Martinez, S: Significant new observations on cervical spine trauma. Am J Roentgenol 1978;130:659–663.
Montana, MA, Richardson, ML, Kilcoyne, RF et al. : CT of sacral injury. Radiology 1986:161:499–503.
Ordog, GJ: Missed cervical spine fractures. Ann Emerg Med 1987;16:726–727. Letter to the editor.
Perdue, P: Urgent priorities in severe trauma: Life-threatening head and spinal injuries. RN 1981;44:36–41, 102.
Podolsky, S, Baraff, LJ, Simon, RR et al. : Efficacy of cervical spine immobilization methods. J Trauma 1983;23:461–465.
Ravichandran, G: Missed orthopaedic injuries in the resuscitation room. J Royal Coll Surg Edinb 1984;29:126. Letter to the editor.
Reid, DC, Henderson, R, Saboe, L et al. : Etiology and clinical course of missed spine fractures. J Trauma 1987;27:980–986.
Ringingberg, BJ, Urdaneta, LF, Midthun, MA: Rational ordering of cervical spine radiographs following trauma. Ann Emerg Med 1988;17:792–812.
Rosen, P: On the evaluation of the traumatized cervical spine. J Emerg Med 1985:3:409–410. Editorial.
Scher, AT: Unrecognised fractures and dislocations of the cervical spine. Paraplegia 1981:19:25–30.
Shaffer, MA, Doris, PE: Limitation of the cross table lateral view in delecting cervical spine injuries: A retrospective analysis. Ann Emerg Med 1981;10:508–513.
Slack, CM: The spine in sports. Compr Ther 1980;6:68–74.
Streitwiesser, DR, Knoop, R, Wales, LR et al. : Accuracy of standard radiographic views in detecting cervical spine fractures. Ann Emerg Med 1983;12:538–542.
Sumachai, AP: Missed cervical spine fractures. Ann Emerg Med 1987;16:726–727.
Suomalainen, O, Kettunen, K, Saari, T: Computed tomography of spinal and pelvic fractures. Ann Chir Gynaecol 1983;72:337–341.
Tator, CH, Ekong, CE, Rowed, DW et al. : Spinal injuries due to hockey. Can J Neurol Sci 1984;11:34–41.
Vines, FS: The significance of “occult” fractures of the cervical spine. Am J Roentgenol Redium Ther Nucl Med 1969;107:493–504.
Wales, LR, Knoop, RK, Morishima, MS: Recommendations for evaluation of the acutely injured cervical spine: A clinical radiologic algorithm. Ann Emerg Med 1980:9:422–428.
Walter, J, Doris, PE, Shaffer, MA: Clinical presentation of patients with acute cervical spine injury. Ann Emergy Med 1984;13:512–515.
Webb, SB, Berzins, E, Wingardner, TS et al. : Spinal cord injury: Epidemiologic implications, costs and patterns of care in 85 patients. Arch Phys Med Rehabilitation 1979:60:335–340.
White, AA 3d, Panjabi, MM, Posner, I et al. : Spinal stability: Evaluation and treatment. Instr Course Lect 1981;30:457–483.
Woodring, JH, Lee, C, Jenkins, K: Spinal fractures in blunt chest trauma. J Trauma 1988;28:789–793.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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