5-26. COMMON ERRORS IN MANAGEMENT

Remember that the goals in treating a patient with a possible spinal cord injury are to support the patient's vital functions (airway, breathing, and circulation) and to keep the patient from sustaining more injury. Improper management of the patient can result in permanent, nonreversible, devastating injury. Look at these common errors in managing a patient with a possible spinal cord injury.

a. Too much reliance on soft collars.

b. Improper use of chin straps. Use of chin straps are only beneficial if the mouth is closed and molars seated. The patient may vomit and aspirate; therefore, avoid using chin straps.

c. Ineffective immobilization, such as the following:

(1) Devices not properly anchored.

(2) Ties applied around the legs, allowing the device used to move if the legs of the patient move.

(3) Patient's head not immobilized properly.

(4) Patient's feet not tied together.

d. Patient's head in an improper position. Avoid hyperextension, overpadding, or collars which are too large.

e. Lack of concern for other injuries when applying an immobilization device.

f. Immobilization of the patient's chest inhibiting ventilation.

g. Patient is moved too much when the immobilization device is applied.

h. Rotary stress placed on the patient when the straps are being tightened, etc.

i. Immobilization of the patient's head before the patient's trunk is immobilized.

j. Sandbags are used with a long spineboard.

k. Short board is not used properly in conjunction with the long board.

l. Too much time is spent mechanically immobilizing the patient's spine when intervention for other injuries is needed.