Purpose of pathway

To clarify the immobilisation strategy for patients requiring Poly-Trauma CT Scans (anything more than an isolated CT Head)

Presumed level of immobilisation – Trauma-Board or Scoop + Blocks (+/- Hard Collar) *

• Triple immobilisation with board, blocks and collar remains the gold standard for immobilisation in adult trauma patients. The use of a hard collar remains best practice when it can be safely tolerated.
• *The decision not to use a collar does not need to be specifically documented on EPR or communicated with the CT radiographer as it applies to a large proportion of trauma patients and would be impractical to do so.
• When a patient cannot tolerate full immobilisation (or it is not clinically required**) then the rationale for this must be documented on EPR by the responsible clinician along with the alternative immobilisation strategy

** e.g delayed presentation patients who have been mobile for a prolonged period of time without suspicion of spinal injury.

Examples of alternative strategies

• Trauma board with no c-spine immobilisation***
• Blocks on trolley and log roll for transfer
• For pat-slide only

*** Trauma boards can still be valuable in patients who cannot tolerate c-spine immobilisation as it will help limit other spinal movement. Extra care will be needed to support the patients head/neck in cases of vomiting when the board needs tilting.

Thanks to Stuart Mitchell and the Trauma Team