UMEM Educational Pearls

Category: Trauma

Title: Paramedic clearance of cervical spine injuries

Keywords: EMS, C-Spine, Canadian C-Spine Rule, spinal injury, trauma (PubMed Search)

Posted: 3/5/2023 by Robert Flint, MD
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Applying a cervical collar to all patients involved in motor vehicle collisions and mechanical falls has been shown to add to patient discomfort, unwarranted imaging studies and prolonged on scene time for emergency medical services. This study adds further evidence that paramedics can use validated algorithms to clinically clear cervical spine injuries without any bad outcomes including spinal cord injuries. EMS medical directors and all of us who interact with EMS providers should be proactive in developing protocols to use cervical immobilization in appropriately selected patients only.  This study used the Modified Canadian C-Spine Rule. 

References

Implementation of Modified Canadian C-Spine Rule by Paramedics

Christian Vaillancourt, Manya Charette, Julie Sinclair, Richard Dionne, et al

Annals of Emergency Medicine Volume 81, No.2 February 2023. 187-196.