Protocol 2-814 - Spinal Cord Trauma

CMH EMS & MIH Protocols

EMD:

No specific protocol.

EMR:

Consider SMR. C-collar is contraindicated with penetrating neck trauma.
Assist Ventilations as needed.
Consider Oxygen 100%.
Consider applying Cardiac Monitor limb leads.
Maintain body temperature between 91° and 99° F.

EMT:

Ensure completion of applicable items above.
Sporting Event Standby:

Park the emergency vehicle in a manner to allow view of the scene from a distance but always have the ability to leave the scene in an expedient manner.
Make contact with athletic trainers upon arrival (if they are present).
Prepare equipment for rapid deployment.
If medical care is needed for a player, event staff should wave EMS onto the field/track if you are needed.
Football player or other event with significant padding and helmet:

Assist athletic trainers in removing athletic equipment prior to transport.
If unable or not recommended by athletic trainer, secure player to Backboard with helmet and pads remaining in place.
Apply C-collar and Backboard if spinal injury is suspected.
Use 8-person lift or scoop stretcher to move patient from the ground to the backboard. Avoid use of log-roll procedure unless posterior inspection is required.
Utilize athletic trainer staff and equipment for Extremity splinting.

Preferred to request second unit to transport and standby unit remain at event.

Consider requesting a second unit to cover standby if critical patient.
Athletic training staff may ride with patient in back if requested.
Air Ambulance landing zone should not be on the playing field.

A standby PCR report shall be completed for all dedicated standbys. Be specific about which standby it is and which location.

AEMT:

Ensure completion of applicable items above.
Consider IV LR titrated to maintain SBP according to age.

Refer to Protocol 2-924 - Universal Patient Care and do not exceed the lower range of the SBP indicated in the Normal Vital Signs table.

RN:

Ensure completion of all applicable items above.
Consider IO LR.

Medic:

Ensure completion of all applicable items above.
Consider Protocol 2-044 - Airway: RSI.

CP:

Ensure completion of all applicable items above.

NEMSIS Protocol: 9914107 - Injury-Spinal Cord

Citations:

Protocol 9-010 - References
Citizens Memorial Hospital, 2012
National Athletic Trainers Association, 2015
NASEMSO Medical Directors Council, 2017

Change Log:

Date	Link to previous version	Description of change
10/04/13	pdf	Changed ALS bag to first-in bag. Changed will to may provide ALS ambulance.
01/29/14		Coordinated protocol with CMH policies.
12/12/14	pdf	Made Intubation and RSI DELIBERATE ACTIONS. Added weight-based dose for greater than 65 yr for Fentanyl.
04/03/15	pdf	Modified this section to reflect other vehicle standbys at events other than just an ambulance.
04/14/15		Added consider to limb leads.
09/22/17	pdf	Added contraindication for c-collar for penetrating neck trauma.
07/23/19	pdf	Added link to new hemorrhage protocol.
04/18/20	pdf	Added content (without substantive modification) from old Protocol 6-080 - Event Standby.
11/13/20	pdf	dded content (without substantive modification) from old Protocol 5-080 - Spinal Trauma.
06/06/21	pdf	Moved to emsprotocols.online
03/16/23	pdf	Clarified RN and medic roles. Added CP.
03/19/23		Changed links for LR.

Return to Protocols Table of Contents.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.