Spinal injury and disability

The Peninsula Trauma Network (Top to bottom, left to right): Royal Cornwall, Torbay, Derriford, Royal Devon & Exeter, North Devon District Hospital.

About the podcast

For a change of roles, Jake is interviewing Tim Nutbeam on the topic of suspected spinal cord injury and management of these patients. Tim’s extensive pre-hospital work with the air ambulance service, along with his latest work with fire and rescue services on evidence-based RTC victim extrication standards puts him in the perfect position to talk us through this area of trauma care!

Tim talks through the shift away from a standard protocol of triple imobilisation for all to a patient-centric and pragmatic approach based on the patient in front of you. We go through some of the neurological complications seen in the small subset of trauma patients who do have a spinal cord injury and how best to manage these in the emergency phase and in their ongoing management.

This podcast needs to be used in conjunction with your logbook to complete all the spinal injury learning areas, particularly around demonstrating how to transfer and mobilise patients with suspected spinal cord injuries.

Check the show notes for the learning areas for the level 1 and 2 Major Trauma Nursing competencies covered in this podcast, along with other useful resources and recommended podcasts.

Spinal injury and disability – ThePTN podcast

We talk about the move away from the historical paradigm of triple immobilisation for all suspected C-spine injuries. Then, we discuss the patterns of injury spinal cord injury seen and how to manage these patients.

Learning areas in this podcast:

  • Understands the indications for c-spine immobilisation and when to initiate it, and when the risk of using spinal precautions outweigh the benefits; the nurse/AHP must speak to a senior clinician about this and then document accordingly
  • The nurse/AHP can outline the key considerations in the care of the spinal cord injured patient: such as the potential effects on temperature regulation
  • The nurse/AHP has an awareness of autonomic dysreflexia
  • The nurse/AHP has an awareness that spinal cord injury may mask signs and symptoms of other injuries
  • Demonstrates an awareness of the signs and symptoms of spinal shock, and how this differs from neurological shock
  • The nurse/AHP has an awareness that spinal cord injured patients require regular pressure area care, and can verbalise the rationale for this need

Links:
Canadian S-spine rules via MDcalc here. Also available on the MDcalc app

NEXUS Criteria for C-spine imaging on MDcalc here.

American Spinal Injury Association examination chart available via ASIA website here.

Back to Podcasts