Neck stabilization in trauma patient: an emergency medicine perspective

Abstract

Spinal trauma is among the most common causes of death among young and healthy individuals. Additionally, due to disability, spinal injury places an enormous burden on both the economical system and the society itself. The main principle of managing early spinal injury in an emergency setting is to stabilize the patient to prevent movement and further deterioration of the patient’s status. This procedure is especially important in the suspicion of cervical spine trauma due to the vital nerves that run through this part of the spine. The cornerstone of diagnosis of spinal damage is CT although it is not perfectly suited for the assessment of the spinal cord injury. The golden standard for the assessment of the extent of damage is MRI, which allows for the best visualization of the soft tissues. To date, there have been developed several devices which allow for the immobilization of the spine. The most commonly used is the cervical collar which restricts the movement of the neck, therefore preventing further damage to the spine. The second device is called longboard, on which the patient is laid and then attached by the straps. While easy to use and fast to apply, the guidelines recommend against the use of the said device and place its role more toward quick extraction devices. The same guidelines recommend the vacuum mattress as a method of choice for transporting patients. Although stabilization is important there are some groups of patients who do not benefit from immobilization. The scales that facilitate the decision-making process are easy to use and achieve high sensitivity.