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Spinal motion restriction in frailty — DipIMC MCQ

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ModerateTraumaSpinal motion restriction in frailtyDipIMC

A 76-year-old has fallen down six stairs and has midline neck pain. He is alert, stable and neurologically intact but very kyphotic and frail. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Use manual in-line stabilisation and patient-centred immobilisation with padding

Use manual in-line stabilisation and patient-centred immobilisation with padding is the best answer because spinal motion restriction should reduce movement without forcing harmful positioning in a frail patient. Wait for imaging before intervening is less appropriate because imaging is not available or appropriate before treating a clinical life threat; Give a large crystalloid bolus before controlling the injury is less appropriate because fluid cannot replace early control of bleeding or ventilation problems. Perform a full secondary survey before treating the abnormality and Transport without treating the identified time-critical problem are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Major Trauma NG39