Spinal Cord Injuries and Turning Q2

[katmarieRN]

I work at a Trauma ICU where often our patients are in C-collars until spines are cleared-- presuming ligament damage when no vertebral damage is seen in CT.

I know this is a silly question... but I cannot find it anywhere. Do you hold C-spine when ruling out ligament damage or when ligament damage is suspected? We don't have any guidelines on our unit.

Also, when to break the bed vs log roll only... we are getting conflicting orders from our MDs also.

Ideally, I would love to find a chart or algorithm that would cover turns and level of spinal injury and make it less ambigious.

TIA!

Kat

[all4schwa]

Rigid collar until bony cleared with films/ct, then soft collar till soft tissue clear. If they can't speak or follow commands, they'll need a flex ex film for them to clear.

HOB flat and log roll only until surgical fixation and or braced, they still need turned q2 using a log roll method. Some exceptions may be transverse process fxs, or of the lumbar spine. Depends on location or severity of fx (risk of cord compression) which may he why you face conflicting orders.

This is my basic understanding......

[katmarieRN]

Thank you!

[ChicagoICUNurse]

Better safe, than sorry! I tend to take a more conservative approach and stabilize c-spine until cleared.