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A PHOTOGRAPHIC GUIDE TO PREHOSPITAL SPINAL CARE: EDITION 5
PAGE 2
This manual has been produced for training and educational purposes only and is not for sale. It
can be downloaded for printing (at no charge) at
www.emergencytechnologies.com.au/psm.htm
under the conditions listed below.
First published May 1995 in Australia by:
Anthony Hann
200 Sinclair St South
Elliminyt
Victoria
Australia 3250
Fifth edition completed and published 20 August 2004
Copyright © Emergency Technologies January 2001
For any issues relating to this publication, contact:
Emergency Technologies
200 Sinclair St South
Elliminyt
Victoria
Australia 3250
Email: emtec@bigpond.net.au
This publication is copyright. Permission is given for any individual or organisation to download and
print one or more copies of this manual as required for educational or training purposes. Otherwise,
no part of this publication may be produced for financial gain (whether directly or indirectly), by any
means (whether electronic, micro copying, photocopying, mechanical or otherwise) without prior
permission from Emergency Technologies or their subsequent company/companies.
Emergency Technologies wishes to acknowledge the assistance of the following in the production of
this manual:

Alexandra & District Ambulance Service

Bacchus Marsh SES International RCR Team

Ford Australia Pty Ltd -
www.ford.com.au

Holmatro Rescue Equipment -
www.holmatro.com

Justin Kibell -
www.techrescue.org

Luke Dam - SES Frankston

RAPP Australia Pty Ltd -
www.neann.com

Rick Kehoe - MICA Paramedic

Rural Ambulance Victoria - Colac Station
The information presented in this manual has been produced for information and educational
purposes only. Whilst all efforts have been taken to provide the latest up to date information
available, the author and Emergency Technologies do not accept any liability to any person, group
or organisation for the information, advice or techniques presented in this manual.
A PHOTOGRAPHIC GUIDE TO PREHOSPITAL SPINAL CARE: EDITION 5
The Manager
INDEX
PAGE 3
I
NDEX
A PHOTOGRAPHIC GUIDE TO PREHOSPITAL SPINAL CARE: EDITION 5
NDEX
INDEX
PAGE 4
TABLE OF CONTENTS
INTRODUCTION …..……………………………………………….
9

Introduction ………………………………………………….
10

Terminology …………………………………………………
10

Training ………………………….……...……………………
10

Equipment ……………………………………………………
11

Course Manual ………………………………………………
11

Additional Copies Of This Manual ……………………….
11

Using This Manual…………………………………………...
11
SPINAL CORD INJURY (SCI) STATISTICS
……………………
12

Australian Spinal Injury Units …………………………….
13

Number Of SCI Patients ……………………………………
13

Prevalence of Traumatic SCI ……………………………...
14

Level Of SCI .…………………………………………………
15

Extent Of SCI …………………………………………………
16

Causes Of SCI ...……………………………………………..
17

Bibliography ………………………………………………....
18
ANATOMY OF THE SPINE …………...……….…...…………….
19

Central Nervous System ……….…...……………………..
20

Peripheral Nervous System ………………………………
20

Somatic Nervous System …………………………………
20

Autonomic Nervous System ……………………………..
21

Sympathetic Nervous System ……………………………
21

Parasympathetic Nervous System ………………………
21

Nervous System Flowchart ……………………………….
22

Neurons ………………………………………………………
22

Dendrites ……………………………………………………..
23

Cell Body ……………………………………………………..
23

Axon . …………………………………………………………
23

Oligodendrocytes …………………………………………..
24

Schwann Cells ………………………………………………
24

Nodes Of Ranvier ……………………………………………
24

Synaptic Cleft ………………………………………………..
25

Spinal Cord …………………………………………………..
25

Spinal Nerves ………………………………………………..
26

Blood Supply To The Spinal Cord …...…………………..
26

Meninges ……………………………………………………..
27
A PHOTOGRAPHIC GUIDE TO PREHOSPITAL SPINAL CARE: EDITION 5
INDEX
PAGE 5
ANATOMY OF THE SPINAL CORD (Continued)

Denticulate Ligaments ……………………………………..
28

Spinal Column ………………………………………………
28

Vertebrae ……………………………………………………..
29

Spinal Sections …………………………………………...…
29

Cervical Spine ……………………………………………….
30

Thoracic Spine ………………………………………………
30

Lumbar Spine ………………………………………………..
30

Sacral Spine …………………………………………………
31

Coccyx Spine ……………………………………………….
31

Vertebral Discs ………………………………………………
31

Spinal Ligaments ……………………………………………
31

Muscles Of The Spinal Column ………………………….
32
ETIOLOGY OF SPINAL CORD INJURY …..…………………..
33

Introduction ………………………………………………….
34

Primary Spinal Cord Injury ……………………………….
34

Secondary Spinal Cord Injury …………………………....
36

Functional Classifications …………………………………
38

Incomplete - Complete Classifications ...……………….
39

Bibliography …………………………………………………
41
PATIENT ASSESSMENT ………….……………………………..
42

Introduction .…………………………………………………
43

Patient Approach …………………………………………...
43

Signs & Symptoms Of SCI ………………………………..
44

Limitations Of Signs & Symptoms Of SCI ……………..
48

Mechanisms Of SCI ………………………………………..
49

Spinal Clearance In The Field ...………………………….
49

Criteria For (Selective) Prehospital
Spine Immobilisation ………………………………...
50

Immobilising the SCI Patient ……………………………..
51

Contra-Indications To Re-Aligning The Spine …………
51

Bibliography …………………………………………………
52
MANUAL IN-LINE STABILISATION ……………………….…….
55

Introduction …………………………………………………..
56

Limitations Of Manual In-Line Stabilisation ……………
56

Dangers Of Manual In-Line Stabilisation ……………….
56

Stability During Manual In-Line Stabilisation ………….
56
A PHOTOGRAPHIC GUIDE TO PREHOSPITAL SPINAL CARE: EDITION 5
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