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The NeckSafe App is a clinical decision support tool based upon the NEXUS and Canadian C Spine studies.
By accessing this Application you agree to be bound by the Terms of Use
Terms Of Use
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RESUSCITATION
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The first stage in treatment of any patient is resuscitation. This is easily remembered by the initials
Resuscitation takes precedence over all else.
If the injured person is unconscious, the NeckSafe principles can still be practiced with special attention to managing the Airway with Cervical Spine Control.
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DRSA+BC
Danger
Response
Send 4 Help
D
R
S
Airway PLUS C-Spine Control
A
Breathing
B
Circulation
C
Circulation
The letter C is in Circulation reminds the first-responder that cardiac massage may be necessary if the injured person is in cardiac arrest.
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Breathing
B for Breathing refers to the necessity of performing expired air respiration or Bag Valve Mask resuscitation if the person is not breathing.
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Airway PLUS C-Spine Control
Send 4 Help
S reminds us to Send for help early in this process, usually calling an ambulance or other people to offer assistance in anticipation that person may need to be treated before they are transported to hospital.
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Response
The letter R refers to Response, which is to say eliciting a response from the injured person (usually to determine whether they are conscious or unconscious and if they can tell as anything about the events leading up to the first responder finding them in need of assistance).
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Danger
The letter D reminds us to look for Danger that might compromise not only the injured person but the first responders as well. At no time should those people attending to any injured person put themselves at risk, and if it is not safe to approach an injured person then you should not do so.
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What type of trauma?
Blunt
Penetrating
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?
?
Penetrating Trauma
• Knife
• Gun
• Sharp object causing injury
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Blunt Trauma
• motor vehicle or bike accident
• falls
• sports
• crush injuries
• other trauma
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Neurologic deficit/complaint?
Yes
No
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?
Neurological Deficit/Complaint
Decreased sensation or movement,
"pins and needles",
weakness
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Immobilization not indicated
Transport
USE CLINICAL JUDGMENT:
IF IN DOUBT
>>>>>>>>IMMOBILIZE
TRANSPORT
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IMMOBILIZE
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Is a Head Bed device available, serviceable and are you trained in its use?
Yes
No
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Headbed
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Head in Neutral Position
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Manual Inline Support
Is a C-Collar available, serviceable and are you trained in its use?
Yes
No
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C-Collar
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Is a spineboard, scoop stretcher, split stretcher or vacuum mattress available, serviceable and are you trained in its use?
Yes
No
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If there is no danger to yourself or the injured person, maintain Manual Inline Support with the C-Collar in place and wait for help to arrive
Spineboard
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RAPID TRANSPORT
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Altered level of consciousness?
(GCS < 15)
Yes
No
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?
Glasgow Coma Score
Altered Level of Consciousness
( GCS < 15)
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Glasgow Coma Score Table
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Yes
No
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Spinal Pain
Pain experienced along
the spine, or tenderness when touched.
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Concerning Mechanism of Injury?
Yes
No
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?
Concerning Mechanism of Injury
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• High speed MVA, rollover or ejection
• Diving accidents
• Falls from a great height
• Cave-ins and entrapment
• Injury to the head
• Massive and multi trauma
• Lightning strikes
Yes
No
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Distracting injury?
Inability to communicate?
Presence of/Evidence of Alcohol/Drugs?
Evidence of Alcohol or Drugs
Intoxication or suspicion of alcohol/drug use
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Inability to Communicate
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• Speech or hearing impaired
• Foreign language
• Small children
Distracting Injury
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• Long bone fracture
• Large laceration, degloving, crush
• Large burns
• Visceral injury requiring surgery
IMMOBILIZE
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