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.