Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

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Wilderness and Rescue Medicine

Chapter 15 Review: Spine Injury

• Any traumatic event capable of damaging the spinal column is a positive mechanism for spine injury. • Injury to the spinal column without cord or nerve root injury is the most common. Like other mus- culoskeletal injury, spinal column injury may be stable or unstable. • Unstable column injury increases risk of injury to the spinal cord and nerve roots. Full body stabi- lization and evacuation is the ideal treatment. • The spine assessment criteria are used in cases where a positive or uncertain mechanism of injury exists, but spine injury may not have occurred. • To properly apply the spine assessment criteria, the patient must be cooperative with normal mental status. • A clear spine means no spine injury. • A low risk spine injury is capable of movement self-protection and any pain is tolerable. There is no neurologic deficit. • A high-risk spine injury is a positive MOI with altered level of consciousness or severe pain, persis- tent neurologic deficit, and the inability to move or bear weight. • The ideal treatment for high risk spine injury is whole body stabilization. • High risk spine injury with persistent neurologic deficit is a high-risk problem worthy of an urgent evacuation. • Full-body spine stabilization may increase other risks. Ideal protection may be deferred or modified until other risks are minimized.