• 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

• 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.