UTSW/BioTel EMS TRAINING/SUPPORT BULLETIN

November 2014

EMS TB 14-012

Spinal Motion Restriction Policy – EMS Provider Support

Refer to the UTSW/BioTel EMS Guidelines for Therapy, the Spinal Motion Restriction Policy, and to TB 14-013 C-Collar Selection

Purpose:

To support UTSW/BioTel EMS Providers in the implementation of the new Spinal Motion Restriction Policy in the 2014-2016 UTSW/BioTel EMS System Guidelines for Therapy.

Background:

1. Recent adoption of the new 2014 UTSW/BioTel Spinal Motion Restriction Policy has generated questions regarding patient safety, Receiving Hospital acceptance, and paramedic liability.

Teaching Points:

1. This policy, applied appropriately, is safe for patients. It is based upon medical science and research.   The policy allows EMS Providers to screen patients who are at low risk for spine injury, and to forego application of a cervical collar (c-collar) and/or a long spine board on select, eligible patients. This will improve patient comfort, satisfaction, and equipment utilization.
2. EMS Providers may use their discretion and may apply a c-collar and a long spine board whenever they believe it is prudent to do so. A c-collar and long spine board are “rapidly reversible”.
3. Receiving Hospital Emergency Department and trauma staff members are currently being educated about the policy change. 
4. EMS Providers MUST report to the Receiving Hospital staff that a patient did not meet the criteria for application of a c-collar and/or long spine board. 
5. EMS Providers MUST document the justification for this decision on the ePCR. 
6. Any questions about the policy or any concerns from the Receiving Hospital staff regarding a particular patient shall be directed immediately to BioTel or to the EMS Field Supervisor.

Summary:

• EMS Providers who follow the Spinal Motion Restriction Policy and who document appropriately will be supported by their EMS Field Supervisors, Chief Officers, and the UTSW/BioTel EMS Medical Direction Team.  There should be no concern for personal liability or reprimand, as long as the policy is properly adhered to and appropriate documentation is included on the ePCR.