A method of examining a patient while their spine remains immobilised - ie if there is a risk of unstable vertebrae. This is part of D (and some of E), so ABC should be completed first.
- Explain what is going to happen, to the patient (if conscious) and to those assisting.
- People are at:
- the head (anaesthetist or most experienced assistant)
- the thorax (tallest)
- the pelvis
- the legs (shortest)
- the examiner is on the other side of the patient
- on 3 (or go) called by the head person, the patient is rolled towards the assistants.
- pull the back board out from under the patient
- along with any cut off clothing, twigs, glass and other extraneous material - be careful!
- inspect the back for obvious wounds/deformity
- palpate down the spine to localise any spinal injury
- percuss/auscultate the lungs
- digital rectal examination for perianal sensation and anal tone
- down on 3 (or down) called by the head person
- keeping the head immobilised, undo the cervical collar and examine the cervical spine (see also clearing the cervical spine)
- consider imaging based on clinical findings AND mechanism of injury