The nurse is caring for a client admitted with spinal cord injury. The nurse minimizes the risk of compounding the injury most effectively by:
A. Keeping the client on a stretcher.
B. Logrolling the client on a firm mattress.
C. Logrolling the client on a soft mattress.
D. Placing the client on a Stryker frame.
Correct Answer: D. Placing the client on a Stryker frame.
Spinal immobilization is necessary after spinal cord injury to prevent further damage and insult to the spinal cord. Whenever possible, the client is placed on a Stryker frame, which allows the nurse to turn the client to prevent complications of immobility, while maintaining alignment of the spine. If a Stryker frame is not available, a firm mattress with a bed board should be used.
Option A: Where applicable, manual support of the head and neck should be maintained during any flat surface transfers as an additional safeguard – even if a cervical collar is in situ. If cervical traction is in place, the traction cord should be shortened to maintain the pull of the traction weights during transportation. Alternatively, the traction cord may be tied off to the end of the scoop stretcher or spinal board.
Option B: Spinal cord injuries are serious. They can require a lengthy recovery period and put a person in bed for extended periods of time. Finding the best mattress and bed for spinal cord injury recovery and long-term support depends on the injury.
Option C: Emergency Department staff prefer wherever possible not to have trauma patients arriving on vacuum mattresses directly from the scene of an accident as removal requires additional logrolling of a patient in pain and with unknown injuries. In addition, the vacuum mattress is not suitable to use as a splint for patients with acute pelvic fractures unless they have other means of pelvic splinting in situ. If the fracture is unstable the patient may continue to “bleed out” on releasing the mattress and collapse.
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