When should I move a patient with a potential spinal cord injury?
Move the patient when you need to. To understand and treat the patient’s injuries it may be necessary to move the patient during the initial assessment, rapid trauma exam, and focused history and physical exam. Nonetheless, try to minimize patient movement and when possible combine purposes for movement. For example, when you roll the patient on their side to look for DCAPBTLS on the back slide a backboard under the patient before returning him to a supine position.

Do all motor vehicle accident patients needed rapid extrication?
No. Rapid extrication is indicated when the scene is unsafe for the patient or rescuers or when you are unable to treat ABC life threats in the patient’s current position. If rapid extrication is not needed stabilize the patient in the
position they are found until an extrication team and equipment is prepared to remove the patient from the vehicle.

What speed motor vehicle collision is a positive mechanism for spinal cord injury?
There is no specific speed at which a spinal cord injury will result. The occurrence of the spinal cord injury is dependent on many other factors such as the force involved – axial loading, hyper – flexion, extension, or rotation, or distraction. The use of seatbelts and airbags alters the likelihood of injury. It is incumbent on the prehospital provider to use their own clinical judgment to assess the mechanism for spinal cord injury. When in doubt, immobilize as you gather additional information about the mechanism and the patient.

These FAQs were adapted for an online continuing education lessons for EMTs and paramedics that is currently being produced for RapidCE.com by Emergency Preparedness Systems LLC