C Spine stabalization for the walking wounded

[sheikB]

Hi,

I'm a relatively new nurse working in ER. We see a fair amount of trauma as we are in a remote area, and the closest place.

What is the best way to manage C spine stabalization for those who walk into the ER, or are wheeled in? ie.. a woman is wheeled in from registration with a head, possibly neck/back injury from fall, but walked to the ER. ?? do you lay them on the ground, or tell them to stand up and get in bed with the backboard already laid down. C Collar them while sitting I suppose?

[jnick31]

I would get the c-collar on them then and there and bring the gurney to them. To be honest, they've been stable enough to walk/ wheel to the ER, walking back to a room probably won't do any more harm than is already done, but there is that slight possibility that they've just been lucky so far, so it's more for that than anything. Negligence claims and crap like that.

[jnick31]

I should also say that I've never worked ER but was on a trauma floor for a while. So an ER nurse may have a better solution.

[akulahawkRN, ADN, RN, EMT-P]

Hi,

I'm a relatively new nurse working in ER. We see a fair amount of trauma as we are in a remote area, and the closest place.

What is the best way to manage C spine stabalization for those who walk into the ER, or are wheeled in? ie.. a woman is wheeled in from registration with a head, possibly neck/back injury from fall, but walked to the ER. ?? do you lay them on the ground, or tell them to stand up and get in bed with the backboard already laid down. C Collar them while sitting I suppose?

Have someone take manual C-spine control, do an assessment, looking for any symptoms from C2-T1 dermatomes and myotomes, any deformities/step-offs of any of the spinous processes, if any is found, put them in a properly fitted collar, bring the gurney to them and maintain inline stabilization while they're assisted to a supine position. Your other option is to get a spine board and do a standing take-down, get them onto the board and carefully, while maintaining manual stabilization, they're lifted (board and all) and placed on the gurney. Once on the gurney, you can log-roll the patient off. Once supine in bed, a spine board is not necessary as they actually promote skin breakdown within a couple of hours.

If no physiologic or anatomic findings and no complaints of an unstable head (like it's going to fall off), and no pain, call a provider and given them your findings and chances are pretty good they'll be "released" from C-spine.

No, I'm not a nurse yet. I'm a Paramedic and athletic trainer who is in nursing school.

Mechanism of Injury just tells me where to look for injury. It doesn't tell me if anything is actually damaged.