Cervical Spine Immobilization

[BAMA]

I am interested as to what the procedure is in various institutions
regarding initial Cervical spine films in patients who have been
collared/boarded/immobilized at the scene of trauma.

Often the patient's neck is not in a true AP position when they present to
ER. Do you have a physician "correct" the rotation prior to filming or do
you as a rule shoot the films as the patient is as a discovery exam, to be
completed later with true projections.

Also I would be interested to know what is your EMT/EMS staff's criteria
for these immobilization procedures. Are they directed to attempt to bring
the Cervical spine into an AP (meaning a continous straight line down the
spine) position or are they directed to more or less place the collar in a
position that is tolerable for the patient. (?)

Any information, direction to papers (studies of this issue ie. missed
fractures due to the less sensitive initial films etc.) or EMS/EMT training
literature concerning this situation would be greatly appreciated.

With thanks,

M. Leblond, MRT(R), CDT

[Ed Pike]

One of our EMT's (now a Lieutenant) at Boston EMS has done quite a bit of
research on C-spine immobilization. You may contact him at Boston EMS
1-617-343-2367. His name is Brian Pomadoro. If he can't help you, I am
sure he can refer you to someone who may have the information you seek.
Please let me know how you make out.
Ed Pike, JD, EMT-P--
Visit my Web Page at: http://people.ne.mediaone.net/edpikeesq/index.html

BAMA wrote in message <01be1ae8$ddcbac00$1f945bd1@default>...

>I am interested as to what the procedure is in various institutions
>regarding initial Cervical spine films in patients who have been

>collared/boarded/immobilized at the scene of trauma...... >Also I

would be interested to know what is your EMT/EMS staff's criteria

>for these immobilization procedures......... >