C-spine immobilisation is a controversial topic because of a lack of high quality evidence from clinical trials. Historical approaches have been challenged, however NICE guidance continues to recommend 3-point immobilisation for all patients with suspected spinal injury despite considerable clinical equipoise. In this episode we discuss the complexities of balancing the risks and harms when trying to provide a patient centred approach, rather than a “one-size fits all” model. As always, there are a number of papers, guidelines and resources that you should have a look at (it’s not exhaustive, but a good place to start!) Enjoy! Rob References & Further Reading NICE Guidance Major trauma Spinal injury Faculty of prehospital care consensus statements Spinal immobilisation Minimal patient handling Cochrane reviews Spinal Immobilisation for Trauma Papers of interest Cowley et al 2017 Dixon et al 2015 Benger & Blackham 2009 Hauswald 2015 Hauswald 2013 Michaleff et al 2012 Podcasts RCEM Learning EMCrit
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