Which of the following patients is not indicated for spinal immobilization?

Prepare for the Prehospital Trauma Life Support (PHTLS) exam. Access diverse quizzes and multiple-choice questions, each with hints and comprehensive explanations. Enhance your readiness and confidence for the PHTLS certification exam!

Multiple Choice

Which of the following patients is not indicated for spinal immobilization?

Spinal immobilization is used when there is a reasonable suspicion of cervical spine injury based on mechanism, exam, or altered mental status. It’s not routinely used for penetrating trauma when there are no signs of spinal injury, because immobilization adds delay and may hinder care without improving outcomes. In this scenario, the patient with a knife wound to the chest and a Glasgow Coma Scale of 15 has no signs of cervical spine injury and is fully oriented. The injury is chest-focused, not neck-focused, so immobilization offers no benefit and could delay definitive chest injury assessment and management. Therefore, this patient is not indicated for spinal immobilization. The other scenarios point to immobilization being appropriate: a motor-vehicle crash with intoxication leaves uncertainty about spinal injury, and altered mental status from the mechanism increases risk; a fall from height with loss of consciousness indicates a high-risk mechanism with potential spine injury; neck tenderness on palpation provides a direct sign of possible cervical injury. Those circumstances justify immobilization until spine clearance is possible.

Spinal immobilization is used when there is a reasonable suspicion of cervical spine injury based on mechanism, exam, or altered mental status. It’s not routinely used for penetrating trauma when there are no signs of spinal injury, because immobilization adds delay and may hinder care without improving outcomes.

In this scenario, the patient with a knife wound to the chest and a Glasgow Coma Scale of 15 has no signs of cervical spine injury and is fully oriented. The injury is chest-focused, not neck-focused, so immobilization offers no benefit and could delay definitive chest injury assessment and management. Therefore, this patient is not indicated for spinal immobilization.

The other scenarios point to immobilization being appropriate: a motor-vehicle crash with intoxication leaves uncertainty about spinal injury, and altered mental status from the mechanism increases risk; a fall from height with loss of consciousness indicates a high-risk mechanism with potential spine injury; neck tenderness on palpation provides a direct sign of possible cervical injury. Those circumstances justify immobilization until spine clearance is possible.

More practice questions