This guideline covers the assessment and early management of spinal column and spinal cord injury in pre-hospital settings (including ambulance services), emergency departments and major trauma centres. It covers traumatic injuries to the spine but does not cover spinal injury caused by a disease.It aims to reduce death and disability by improving the quality of emergency and urgent care.
NHS England’s clinical reference group (CRG) produce the service specification for major trauma. The CRG intends to consider the NICE guidelines on major trauma, complex fractures, spinal injury and major trauma: service delivery in future updates to the service specification which are planned for 2017.
This guideline includes recommendations on:
- initial triage and management by pre-hospital care staff
- clinical assessment and management at the emergency department
- acute stage imaging
- communication with tertiary services
- information and support needs of patients and their families and carers
Who is it for?
- Healthcare professionals and practitioners who provide care for people with suspected or confirmed spinal injury in pre-hospital and hospital settings
- People with suspected spinal column or spinal cord injury secondary to a traumatic event, and their families and carers
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.