Spinal Motion Restriction Management

Explain how the spine-board is designed to be used, and some of the risks of using the spineboard if not used appropriately.

You have been dispatched to assist a 26 year old male patient who was shot in a cash-in-transit heist. He has a single entrance wound on the right side of the chest, 4th IC space close to the sternum. He is complaining of severe respiratory distress, is seated upright on arrival and is very pale. He complains that his chest hurts a lot. He tells you he managed to run for cover after being shot, but now he cant walk because he cant breathe.

Vitals as follows:

HR 128b/min

BP: 92/60mmHg

RR: 20b/min

The Canadian C-spine rule recommends that patients who present with a “dangerous mechanism” be managed with full spinal motion restriction. Which of the following mechanisms count as “high-mechanism”?

Discuss your approach to spinal motion restriction for the following patient:

A 40 year old man involved in a high speed motor-vehicle accident, the patient is GCS 5/15, he is being ventilated and is unable to comply with any assessment/instructions.

What devices/equipment or tools or maneuvers should be employed for the management of this patient’s C-spine (and entire spine), describe your approach from the moment you touch the patient to handover at hospital. The patient is currently entrapped in the vehicle.

(Please don’t give information about the clinical approach, we are looking for the approach to C-Spine control only, in relation to his clinical condition)