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miércoles, 4 de mayo de 2016

Spinal and cervical immobilization

Emergency Medicine Blog - May 3, 2016
"Spinal immobilization including cervical immobilization is no longer widely recommended for
ALL trauma patients.
In fact, the American College of Emergency Physicians (ACEP) has come out with a new statement that is against the use of long backboards by EMS (click here to access): 
“Backboards should not be used as a therapeutic intervention or as a precautionary measure either inside or outside the hospital or for inter-facility transfers.” 
Backboards or spinal boards are transport devices, not immobilization devices. The spinal board is hard, but our spine has curvatures, and immobilizing them can aggravate spinal injuries on certain segments (besides risk of pressure sores, etc).
The UK Faculty of Prehospital Care has also similarly discourages spinal immobilization. Click here:http://emj.bmj.com/content/30/12/1067.full.pdf+html 
Bottomline:
  1. An awake patient can probably protect his spine and back better than any of our gadgets can; and should be allowed to self-extricate and lie on the trolley.
  2. A patient who is not fully conscious or fulfill NEXUS criteria should have the neck immobilized - either with good fitting cervical collar or other means for manual stabilization (pillows, blankets)."