title: Spinal immobilization in the field: clinical clearance criteria and implementation.
abstract: Awareness of the health and financial repercussions of unnecessary immobilization has made cervical spinal immobilization controversial in out-of-hospital care. Clinical criteria for clearance of the cervical spine in the hospital based on mechanism of injury have been supported by many trauma centers. However, implementation of clinical criteria for cervical spinal clearance in out-of-hospital settings is not as well validated by multicenter studies or accepted by many emergency departments. This consensus group recommends that clinical criteria to determine "low-risk" patients be available for use by emergency medical services providers in out-of-hospital settings; however, training, audits, quality management, integration into the medical community, and extent of program implementation should be decided based on individual emergency medical services systems.
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, Gold Cross Ambulance, Mayo One Helicopter, and Mayo Medical Communications, Rochester, Minnesota 55905, USA. dhankins@mayo.edu
authors.forename: D G
authors.initials: DG
authors.lastname: Hankins
authors.forename: E J
authors.initials: EJ
authors.lastname: Rivera-Rivera
authors.forename: J P
authors.initials: JP
authors.lastname: Ornato
authors.forename: R A
authors.initials: RA
authors.lastname: Swor
authors.forename: T
authors.initials: T
authors.lastname: Blackwell
authors.forename: R M
authors.initials: RM
authors.lastname: Domeier
mesh_terms: D000367:Age Factors; D002574:Cervical Vertebrae / Q000293:injuries*; D003365:Costs and Cost Analysis; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D013124:Spinal Injuries / Q000628:therapy*; D014481:United States