Transport and Definitive Care

On completion of the primary and secondary surveys (if appropriate) it is essential to understand that the player’s clinical condition may change, and regular re-evaluation is important.

It is equally important that assessments of physiological/vital signs and any peripheral neurological assessments are documented to allow for trends to be identified. This information along with the SAMPLE history should accompany the player to hospital.

The transport of patients with a suspected spinal injury must only be undertaken by appropriately qualified ambulance crews with the right equipment.

Players with spinal pain/tenderness only, and no signs or symptoms of spinal cord injury may be transported to the nearest Emergency Department for definitive care.

Players with signs and/or symptoms of a spinal cord injury should ideally be transported to a major trauma centre with spinal injuries support. This may require transport by Air Ambulance.

There is some evidence that early closed reduction, within 4 hours of injury in bifacet or unifacet dislocations with spinal cord compromise result in improved outcomes compared to delayed reduction (Newton D 2011)