UNCONTROLLED WHEN PRINTED
Indications
  • Immobilisation of patients with suspected spinal injury.
Contraindications
Contraindications
Patient Factors & Considerations
  • Do not readjust the torso straps after the head has been secured. This causes movement of the immobilisation device in relation to the torso.
  • Do not secure the arms inside the spider straps. This causes the straps to be too tight or loose. If the arms need to be secured an additional strap or bandage should be used.
  • Do not secure the base plate of the head blocks or the towel rolls to the Ferno 50/E stretcher. The head and chin straps should be used to keep the blocks in place.
  • Prolonged immobilisation on the extrication board can increase the risk of pressure ulcers. Bony prominences should be sufficiently padded.
  • Should additional padding be required to support the head, this should be placed underneath the head block base plate.
  • In the restless/claustrophobic patient, continuous inline immobilisation might be needed instead of a C-Spine collar and/or head blocks.
  • Ensure adequate assistance is utilised when lifting patient.

Note:

  • Safe work load of the extraction board: 220kg
  • Safe work load of the scoop stretcher: 159kg
Procedure
  • All relevant infection control methods to be utilised.
  • Prepare equipment required:
    • Extrication board/scoop stretcher
    • Head blocks
    • Spider straps
    • Suction (if required)
    • Triangular bandage (if required)
  • Reassure the patient and inform the patient of the procedure that is going to be performed to stabilise the injury.
  • Carefully loosen or cut off any clothing around the neck and remove any neck jewellery.

  • Perform primary survey and provide immediate life saving intervention as required.
  • Check motor ability, sensory response and distal circulation in all limbs (patient’s condition permitting).
  • Examine patient’s neck and apply measured cervical collar.
  • If using the KED; position on the patient.
  • Place patient on the immobilisation device: extrication board (Fig 1) or scoop stretcher and move to stretcher.
  • Consider giving Ondansetron to all potential spinal injured patients.
  • In the event of vomiting suction patients airway and/or log roll.
  • Transport the patient where possible to definitive care. Consider patient condition and history in regards to the position transported (laterally if uncontrolled vomiting, head end elevated if severe head injury or lateral tilt if pregnant).
  • Keep patient warm with blankets (injuries above T6 can cause a loss of temperature regulation).

Extrication

  • Secure patient using the T.H.E. principle
Thorax Immobilise so there is no horizontal or vertical movement possible, utilising padding to fill in the hollows.
Head Pad head to maintain neutral position in adults and stabilise with head blocks. Provide padding beneath the torso and shoulders in paediatric patients to reduce hyper-flexion.
Extremities Immobilise the legs so there is no anterior or lateral movement. In the unconscious patient secure the arms.
  • Re-evaluate the primary survey including motor, sensory and circulation in the extremities.
  • Patients that are not time critical MUST be removed from the extrication board prior to transportation.

Interfacility Transfers

  • Where possible a Vacuum Mattress should be utilised when transferring a confirmed spinal injury patient.
  • Should a vacuum mattress not be available, then the same principles of spinal care should be followed as described previously.
  • Patients should not be transported on the extrication boards or scoop stretchers between facilities.
Spinal1
Success
Success
Discontinue
Discontinue
Additional Information
Additional information

References
References

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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Published Date

Review Date

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