‘Thrombosis Clinic’, Www.Thrombosisclinic.Com

Indications for prehospital spinal immobilization have changed dramatically over the history of modern Emergency Medical Systems. Prehospital practice currently comprises immobilization of essentially all patients with any potential for spinal injury based on mechanism of injury. Costeffective care of trauma patients has advanced significantly, and numerous studies examining indications for spine radiographs in trauma patients have been published. The findings of these studies universally support the use of clinical criteria to determine the need for spinal radiographs. They also support the presumption that without symptoms and physical findings associated with spinal injury, no significant spinal injury exists. Spinal immobilization on a rigid backboard is not without complications. Besides the direct cost of the equipment, there are also significant effects on patient comfort and the cost of Emergency evaluation. Respiratory compromise due to the strapping techniques used and pressure complications from rigid immobilization have been reported. Head and back pain is a nearly universal complication of prolonged rigid spinal immobilization and can alter Emergency department presentation and evaluation, necessitating radiographs that might have been avoided by omitting spinal immobilization in asymptomatic patients.