Table 1 Pre Hospital Care Questions and Responses

1. What protocols guide the care of the patient with acute TSCI in the early hospital phase in your region of practice? (n = 65)

• Paralysed Veterans of America guides (PVA) 2008 [1 (1.5)]

• American Association of Neurological Surgeons/ Congress of Neurological Surgeons (AANS/CNS) 2013 [8 (12.3)]

• American College of Surgeons – Advanced Trauma Life Support (ATLS) [20 (30.8)]

• Locally written [40 (61.5)]

• Other [8 (12.3)]

• None [5 (7.7)]

2. Do you believe neurological assessment in the field is able to correctly identify all cases of TSCI (sensitivity) as well as exclude people without? (n = 66)

• Yes [20 (30.3)]

• No [40 (60.6)]

• Not sure [6 (9.1)]

3. In your region of practice, can a pre-hospital clinician make the decision to transport the patient with an apparent isolated TSCI directly to a dedicated SCI service? (n = 65)

• Yes [37 (56.9)]

• No [20 (30.8)]

• Not sure [8 (12.3)]

4. In your view, should all patients with a suspected TSCI (apparent paralysis and/or numbness or sufficient doubt because of altered mental state or major injury) receive spinal immobilization at the scene of injury? (n = 66)

• Yes [64 (97)]

• No [2 (3)]

5. In your view should all patients with a potential TSCI (due to mechanism, spinal pain or sufficient doubt because of altered mental state or major injury), but no apparent paralysis or numbness receive spinal immobilization at the scene of injury? (n = 66)

• Yes [50 (75.8)

• No [16 (24.2)]

6. What devices (or combination of devices) would the clinician use for extrication?

(NB: participants could choose multiple responses) (n = 66)

• Rigid extrication collar [51 (77.3)]

• Backboard with straps [47 (71.2)]

• Semi-rigid cervical collar [14 (21.2)]

• Soft foam collar [3 (4.5)]

• Sandbags [30 (45.5)]

• Other [18 (27.3)] (free responses included the ‘Kendrick extraction device, ‘NEANN Immobilisation and Extraction Jacket’ (NIEJ); scoop for extrication; vacuum mattress and backboard with no straps)

7. What devices would you use for spinal immobilization for transport? (NB: participants could choose multiple responses) (n = 66)

• Rigid extrication collar [51 (77.3)]

• Backboard with straps [27 (40.9)]

• Semi-rigid cervical collar [15 (22.7)]

• Soft foam collar [5 (7.6)]

• Sandbags [39 (59.1)]

• Other [12 (18.2)] (such as vacuum mattress, stretcher if transport > 60 min; stretcher harness and coop stretcher with straps)

8. In your region of practice, are patients with a TSCI transferred directly from the scene of injury to the SCIU in your state? (n = 66)

• Rarely [12 (18)]

• Sometimes [33 (50)]

• Most of the time [19 (28.8)]

• Always [2 (3)]

9. In your region of practice, are patients with a TSCI transferred initially from the scene of injury to a major trauma service (without a co-located SCIU) in your state? (n = 65)

• Rarely [8 (12.3)]

• Sometimes [14 (21.5)]

• Most of the time [33 (50.8)]

• Always [10 (15.4)]

10. In your region of practice, is it always achievable to contact the SCIU within 2 h of the patient injury and achieve transfer within 24 h? (n = 60)

• Yes [38 (63.3)]

• No [22 (36.7)]

11. In your region of practice, does the SCIU have, and adhere to a ‘non-refusal’ policy? (n = 64)

• Yes [23 (35.9)]

• No [19 (29.7)]

• Don’t know [22 (34.4)]

12. In your region of practice, is airway intubation ever performed in the field in the setting of TSCI? (n = 64)

• Yes [49 (76.6)]

• No [2 (3.1)]

• Don’t know [13 (20.3)]

13. If not currently practiced, in the clinician’s view, is there a role for airway intubation in the field in appropriate cases of patients with TSCI? (n = 56)

• Yes [51 (91.1)]

• No [5 (8.9)]