Table 2 Early Hospital Care Questions and Responses

1. What organisationally proscribed guidelines guide your early hospital care of patients with acute TSCI? (n = 71)

• Unsure [20 (28.1)

• No particular guideline [12 (16.9)]

• Trauma Protocols including Early Management of Severe Trauma, Advanced Trauma Life Support®, state-based Major Trauma guidelines, other Trauma Protocol [22 (30.5)]

• Locally written [11 (15.5)]

• Statewide Spinal Cord Service Protocol [4 (5.6)]

• AANS recommendations [2 (2.8)]

2. In your current practice, do you aim to remove patients from a backboard within 15 min from their arrival? (n = 61)

• Yes [44 (72.1)]

• No time frame [5 (8.2)]

• Not sure [4 (6.6)]

• Other [8 (13.1) (“never use backboard for transport”, “remove backboard as soon as patient on stretcher with spinal rated mattress”)

3. What methods do you use to protect the cervical spine? (n = 60)

(participants could choose multiple responses)

• Leave rigid collar in situ [25 (41.7)]

• Replace rigid collar with a semi rigid collar (Philadelphia/Aspen/similar) [35 (58.3)]

• Sand-bags and tapes [20 (33.3)]

• Other [12 (20)] (e.g. sandbags with no tapes; spine splints, vacuum mattress; manual in-line stabilisation, stretcher harness and handling such as log roll)

4. In which patients do you utilize the log-roll manoeuvre? (n = 60)

• All major trauma (defined by mechanism or physiological parameters) [49 (79)]

• Only those with suspected spinal column injury (mechanism and/or spinal pain, presence of confounding factors)

[17 (27.4)]

• Only those with neurological deficit [2 (3.2)]

5. If you log-roll, how many staff members are called upon to move, turn the patient needing spinal immobilization? (n = 62)

• 2 [2 (3.2)]

• 3 [10 (16.1)]

• 4 [43 (69.3)]

• 5 [5 (14.5)]

• 6 [2 (3.2)]

6. In your practice how frequently do you perform pressure area care with skin inspection? (n = 57)

• Every hour [7 (12.3)]

• Every 2 h [29 (50.9)]

• Every 3 h [3 (5.3)]

• Every 4 h [1 (1.8)]

• Once per shift [2 (3.5)]

• Other [15 (26.3)] (most reported following instructions from spinal physicians)

7. Do you have specialised beds available within 2 h of a patient with confirmed TSCI being admitted to your service? (n = 57)

• Yes [19 (33.3)]

• No [28 (49.1)]

• Not sure [10 (17.5)]

8. What indicators of respiratory failure do you measure in known cervical spinal cord injury? (n = 55)

• Vital capacity [4 (7.3)]

• Arterial blood gases [14 (25.5)]

• Both of the above [22 (52.7)]

• Other [15 (27.3)] (included pulse oximetry, tidal volume, and respiratory rate)

9. What are your indications (any or all) to intubate patients with a cervical spinal cord injury? (participants could choose multiple responses) (n = 58)

• Clinical evidence of respiratory distress [51 (87.9)

• Poor or deteriorating vital capacity/ABGs [44 (75.9)]

• All cases prior to air transport [5 (8.6)]

10. Is high dose methylprednisolone used in your area of practice to treat TSCI? (n = 55)

• Yes [6 (10.9)]

• No [49 (89.1)]