Spinal immobilisation with Jim Walmsley

In this conversation we will examine the recent changes in spinal
immobilisation within pre-hospital practice. We will look at the
historic literature, prevalence of spinal injury in reality, the
RCSEd recommendations, and other international guidelines and
also the current practice of C-spine collars and extrication
advice. To do this I have Jim Walmsley with me, Jim is a
Critical Care Paramedic at South East Coast Ambulance Service NHS
Foundation Trust. Jim has a 19-year history with the ambulance
service and has focussed his career on clinical practice,
research, under-graduate teaching, as well as managerial duties.
In the episode we discuss: • The culture and historic research of
spinal immobilisation. • Pre-hospital prevalence & cultural
shift • What are the main considerations in the pre-hospital
phase of care • Pre-hospital assessment (sensitive? Valid?) main
information to take note of (MOI & other factors) • Immediate
treatment options – to immobilise or not immobilise • Latest
recommendations • Seminal cases where the application of the
above has worked well • Final thoughts & take-home messages.





Some of the references that Jim referred to can be found here:


https://fphc.rcsed.ac.uk/media/1757/pre-hospital-spinal-immobilisation.pdf


Canadian C spine rules:


https://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/for-professionals/whiplash-resources/SIRA08109-Canadian-C-Spine-Rule1117-396476.pdf


NEXUS guidelines:


https://www.ebmedicine.net/media_library/files/Trauma-Imaging-Resuscitation-CD.pdf


Accuracy of the Canadian C-spine rule and NEXUS to screen for
clinically important cervical spine injury in patients following
blunt trauma: a systematic review


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494329/





My thanks to Jim for an engaging and insightful interview.