spinal clearance protocol

[british bird]

hi there!

we're currently auditing the problems associated with delays in clearing spines, in trauma patients. Does anyone out there already have a protocol in place? Once radialogically cleared do you remove hard collars or do you wait until the patient is able to report whether or not they have neck pain?

[Elenaster]

Ours have to have them cleared by radiology. Most of our patients are intubated and/or neurologically impaired, so we can't rely on them.

[TraumaNurse]

We generally switch patients to a long term stiff collar such as a Miami J or Aspen. After being radiographically cleared, if the patient is not awake or able to tell whether they have pain on palpation, then an MRI can be done to rule out ligamentous injury. The MRI usually has to be done within 72 hours of injury.

[kc ccurn]

It depends on the patient. If they are alert and oriented and can tell us where or not their neck hurts or is tender to palpation and is cleared by 6 view xray. If they are coma or TBI then we also go to CT to r/o fx, MRI for ligament injury.

[dorimar, BSN, RN]

ok... but how the blank do you get them on and off the mri table safely?

[monkeyman1000]

our trauma docs leave them in the collar (usually an Aspen) until they are both cleared radiographically and the patients are able to tell them they aren't hurting to palpation. Sometimes they are in a collar a long, long time.