How paramedics apply the spinal immobilisation algorithm in trauma patients

Background: Validated criteria are included in the algorithm used in the UK prehospital setting to safely reduce the number of traumatically injured patients requiring full spinal immobilisation. The criteria improve the sensitivity in selecting patients with spinal injuries but evidence how UK ambulance clinicians apply them is sparse. Aims: This study aimed to identify the knowledge levels and the use of the spinal immobilisation algorithm by ambulance clinicians. Methods: A quantitative survey used a convenience sample of all frontline clinicians in London Ambulance Service NHS Trust. Findings: The algorithm is not routinely used when assessing traumatically injured patients at risk of spinal injury; recognition of the algorithm inclusion criteria is poor, especially regarding patients under the influence of drugs or alcohol. There is a belief that too many patients are immobilised unnecessarily. Conclusion: Research is required on how ambulance clinicians use checklists and paramedic education on spinal immobilisation rules requires review.