Key Messages

The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This spinal trauma guideline provides evidence-­‐based advice on the initial management and transfer of major trauma patients who present to Victorian health services with spinal injuries.

This guideline is developed for all clinical staff involved in the care of trauma patients in Victoria. It is intended for use by frontline clinical staff that provide early care for major trauma patients; those working directly at the Major Trauma Sevice (MTS) as well as those working outside of a MTS. These spinal management guidelines provide up-to-date information for frontline healthcare clinicians.

These guidelines provide the user with accessible resources to effectively and confidently provide early care for critically injured spinal patients. The guideline has been assessed utilising the AGREE methodology for guideline development and is auspiced by the Victoria State Trauma Committee.

Clinical emphasis points

The early management of trauma patients should emphasise the possibility of a spinal injury with a focus on clinical protective mechanisms.
  • Protective handling is essential to minimise secondary spinal cord injury in the early management of spinal trauma.
  • Regular neurological assessment should be undertaken to monitor for progressive deterioration in function.
  • Deteriorating respiratory function in a spinal trauma patient may indicate the need for intubation. This requires specific planning and intervention.
  • Once the patient is identified as suffering from a spinal injury, early activation of the retrieval process is crucial.
  • All polytrauma patients are ideally managed at an MTS. Adult trauma patients with an isolated spinal injury should be transferred to the Victorian Spinal Cord Service (VSCS), Austin Health.
  • ARV is the first point of call to initiate retrieval and transfer in the adult patient.
  • The main goal of early care is to ensure optimum resuscitation in the emergency setting as well as activation of the retrieval network, with timely transfer to an appropriate facility.

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