Trained PersonnelTrained PersonnelMaintain spinal alignmentMaintain spinal alignmentMaintain hemodynamic stability Maintain hemodynamic stability

Extrication TechniquesExtrication Techniques

Extrication from site of Extrication from site of AccidentAccident

RETREIVAL FROM WATER OF A SUSPECTED CERVICAL SPINE INJURY

RETREIVAL FROM WATER OF A SUSPECTED CERVICAL SPINE INJURY

First Aid at Site of AccidentFirst Aid at Site of Accident

Airway maintenance

Breathing

Circulation with hemorrhage control

Disability : assessment for neurologic disability

Exposure : as soon as possible and skin surfaces observed for changes

Most appropriate and expeditious method depending on

- Patient’s medical condition &

- Distance from accident site to closest or most appropriate receiving hospital

MODES OF TRANSPORT

Land TransportTime enroute 45 minutes or less

HelicopterRelatively stable injuriesRequire transport over extended distance (30-150 km) High density traffic

Fixed wing transportPatients requiring tertiary medical care more than 150 km away

MODES OF TRANSPORT

Physical Evaluation Physical Evaluation

MOTOR SENSORY RESPONSE Intact LevelMOTOR Diaphragm C3,4,5 Shrug shoulders C4 Deltoids(and flex elbows) C5 Extend wrist C6 Extend Elbow/Flex wrist C7 Abduct fingers C8 Active chest expansion T1-T12 Hip Flexion L2 Knee extension L3-L4 Ankle dorsiflexion L5-S1 Ankle plantarflexion S1-S2SENSORY Anterior Thigh L2 Anterior Knee L3 Anterior Lateral Ankle L4 Dorsum great second toe L5 Lateral side of Foot S1 Posterior Calf S2 Perianal Sensation S2-S5

Neurology Function – Level of Intactness

EVALUATION OF PATIENTEVALUATION OF PATIENT

Impairment evaluation paradigm Impairment evaluation paradigm American Spinal Injury Association (ASIA)American Spinal Injury Association (ASIA)The International Classification of Functioning The International Classification of Functioning (ICF)(ICF)

Disability measureDisability measureFunctional Independence Measure (FIM) Functional Independence Measure (FIM) Spinal Cord Independence Measure (SCIM) Spinal Cord Independence Measure (SCIM)