31 May 2015
The Importance of Correct Ambulance Care Following a Spinal Cord Injury
A recent clinical negligence case where a paramedic was found liable for manhandling a patient, and causing his spinal cord injury (SCI) to deteriorate, has highlighted the importance of correct ambulance care following a SCI.
In the case of Griffiths v The Secretary of State for Health (2015) an ambulance service provider was found to have failed to immobilise a patient’s neck before moving him into a sitting position.
The ambulance officers mistakenly assumed the patient had suffered a stroke. This negligence was never disputed but it remained to be determined whether the failure was responsible, at least in part, for his residual disability.
The court concluded that there was evidence of manhandling by the ambulance staff, and that the manhandling was responsible for the deterioration of his condition.
Whenever an ambulance crew attend someone who has suffered a suspected SCI, treatment begins with an initial evaluation followed by the immobilisation of the patient for transport.
Immediate medical care within the first 8 hours is crucial to a patient’s recovery. Nowadays there is much greater knowledge about how to correctly move and handle spinal injury patients as incorrect techniques employed at this stage could significantly worsen a patient’s injuries.
The majority of traumatic SCI in the UK are attributable to road traffic accidents (50%), falls (43%), and sport injuries (7%).
Spinal injuries should always be assumed until proven otherwise, in the following circumstances:
- A patient is unconscious following a road traffic accident
- A patient has suffered multiple trauma
- There are significant injuries below the collar bone
- A patient has fallen more than 10 feet
- Any accident where the impact forces are high
- Any accident where the acceleration or deceleration forces involved the neck
Signs and symptoms of a SCI include, extreme back pain or pressure in the neck, head or back, weakness or paralysis in any part of the body, numbness, tingling or loss of feeling in the hands, fingers, feet or toes, loss of bowel or bladder control, difficulty walking or balancing, fading in and out of consciousness, and impaired breathing after injury.
Even though SCI are relatively rare, spinal immobilisation is one of the most commonly performed pre-hospital procedures.
Spinal immobilisation itself is not without risks as it can take time, potentially delaying crucial specialist treatment. In addition, it can raise intracranial pressure as well as reduce the airway opening, potentially restricting a patient’s breathing.
If a spinal fracture is suspected, the whole spine must be immobilised using either in-line immobilisation where the patient’s head and neck are supported and carefully moved into the neutral position, or triple immobilisation where a collar, head blocks and a spinal board or vacuum mattress are used.
The primary aim of pre-hospital immobilisation is the reduction or prevention of secondary injury. Incorrect treatment at the scene of an injury or during transport to hospital can obviously have disastrous consequences.
Tim Deeming is a Senior Personal Injury Lawyer specialising in Clinical Negligence Spinal Injury cases at Slater and Gordon Lawyers UK. Tim is also an Association of Personal Injury Lawyers Spinal Cord Injury Specialist.
Slater and Gordon Lawyers are proud to be a Diamond Corporate Sponsor of the Spinal Injuries Association, the leading national charity for spinal cord injured people and their families.
If you or a member of your family are affected by spinal cord injury, please call our Spinal Injury team on freephone 0800 916 9046 or contact us online and we will call you.