OBJECTIVES

• Identify patient with spinal injury and is in need of rapid extrication.
• Provide the proper equipment and personnel.

INDICATION OF PROCEDURE

• This protocol is only to be used when the patient life is in immediate danger from environmental factors or due to patient condition.
• Environmental
  • Fire.
  • Explosion hazards.
  • Danger of building collapse.
  • Hazardous material exposure.
• Patient condition
  • Uncorrectable airway obstruction.
  • Cardiopulmonary arrest.
  • Injuries resulting in need to assist with ventilations.
  • Uncontrollable bleeding or late stage shock condition.

PROCEDURE

• Rescuer one should be positioned behind the patient to stabilize the neck and head. and have a second EMT apply a cervical collar.
• Rescuer two performs a rapid assessment and applies the proper cervical collar.
• At the direction of the EMT stabilizing the head and neck, two EMTs each lift the patient by the armpits and buttocks/thighs just enough for a bystander or additional rescuer to slide a long spine board between the patient and the vehicle seat.
• The EMTs reposition their hands so the EMT on the front seat inside the vehicle holds the patient's legs and pelvis, while the EMT outside the vehicle holds the upper chest and arms.
• At the direction of the EMT holding the head and neck, carefully turn the patient a quarter turn so his back is toward the door of the vehicle.
• The EMT who was holding the pelvis temporarily holds the chest so the EMT who was holding the chest can take over head and neck stabilization.
• The EMT in the back seat can then reach over the seat and assist with the chest, and the EMT inside on the front seat can move his hands back to the pelvis.
• At the direction of the EMT at the head and neck, gently lower the patient to the spine board. Note: Sometimes it may be necessary to move the patient inside the vehicle a few inches so there is ample room to lay him down without touching the upper door opening.
• As a bystander or additional rescuer holds the end of the spine board, the EMTs slide the patient to the head end of the board.
• As the patient is removed to the long board as a unit by at least three rescuers, fourth rescuer should maintain cervical spine alignment (during the procedure the patient’s neck and back should be maintained in straight, neutral alignment at all times).
• Quickly apply straps to the patient's chest, pelvis, and legs and remove the patient to a stretcher or the ground, under the direction of the EMT stabilizing the head and neck. Note: Since the patient's head is not yet fully immobilized (it is only being manually held stable by the EMT and collar), DO NOT walk more than a few steps with the patient. Once on stable ground or the stretcher, apply a head immobilizer or blanket roll and wide tape.
• Refer to spinal Immobilization protocol.