EMT · Patient Treatment and Transport · 7 min read
Head, Spine, Chest, Abdominal and Musculoskeletal Trauma
- Differentiate clinical presentations and prehospital interventions for life-threatening head, spine, and chest injuries within the EMT scope of practice.
- Formulate an appropriate assessment and stabilization plan for abdominal eviscerations, pelvic instability, and occult internal bleeding.
- Demonstrate proper basic life support splinting, realigning, and management techniques for fractures, joint dislocations, amputations, and suspected compartment syndrome.
Head and Spinal Trauma Assessment and Motion Restriction
Trauma to the head and spine presents an immediate threat to the central nervous system. After ensuring scene safety, an EMT must provide manual in-line stabilization whenever a spinal injury is suspected. Begin manual in-line stabilization as soon as practical, without delaying control of catastrophic bleeding or management of an inadequate airway. Use a jaw thrust first when opening the airway of a patient with suspected cervical spine trauma; if it does not open the airway adequately, use a head-tilt/chin-lift while minimizing neck movement.
Maintain continuous manual in-line stabilization until spinal motion restriction is completely established according to your local protocol. While maintaining manual control, apply an appropriately sized cervical collar. The head should be brought into a neutral position only if this realignment can be achieved smoothly. If the patient experiences severe pain, muscle spasms, resistance, or worsening neurological deficits, you must halt alignment attempts immediately and support the head in the position found.
Spinal motion restriction focuses on minimizing movement without unnecessary discomfort. Depending on your local protocols, motion restriction may involve securing the patient to an ambulance cot or placing them on a vacuum mattress. A long backboard serves as an effective extrication device to move a patient from a wreckage, but it should not routinely be used for prolonged transport. If a patient is wearing a motorcycle or athletic helmet, it may be left in place if it fits securely, allows full airway assessment and ventilatory support, and does not interfere with proper spinal alignment. However, if you decide to remove an athletic helmet, you must also remove the football shoulder pads to maintain a flat, neutral cervical alignment.
Intracranial emergencies demand careful monitoring and gentle intervention. A brief initial loss of consciousness followed by a lucid interval and then rapid secondary deterioration classically indicates an epidural hematoma. In contrast, subdural hematomas commonly involve bleeding from bridging veins beneath the dura mater and may develop either rapidly or gradually over time. If increased intracranial pressure develops, you may observe Cushing's triad, which consists of hypertension, bradycardia, and irregular respirations. Routine hyperventilation must be avoided in head-injured patients because hyperventilation causes cerebral vasoconstriction, which induces secondary brain ischemia. Additionally, if clear cerebrospinal fluid leaks from the ears or nose, loosely absorb the drainage with sterile gauze rather than packing the openings.
Common mistakes
- Continuing to force a patient's head into a neutral position after encountering resistance, muscle spasms, or increased pain during spinal motion restriction.
- Routinely hyperventilating a head-injured patient showing signs of increased intracranial pressure, which causes cerebral vasoconstriction and worsens brain ischemia.
- Packing clear cerebrospinal fluid leaks in the nose or ears with gauze rather than allowing the fluid to drain loosely into a sterile dressing.
- Repeatedly rocking or compressing an injured pelvis to re-check for structural instability, which worsens retroperitoneal bleeding.
- Placing an amputated body part directly into ice water or directly onto frozen ice packs, damaging viable tissue.
Key points
- Provide immediate manual in-line spinal stabilization for suspected spinal trauma, stop alignment if pain or resistance occurs, and maintain restriction until the patient is secured via local protocol.
- After head trauma, cerebrospinal fluid drainage from the nose or ears should be covered loosely without packing; avoid routine hyperventilation to protect cerebral blood flow.
- Manage open chest wounds with vented or occlusive dressings, burping them if tension pneumothorax signs develop, and provide positive-pressure ventilation for flail chest with respiratory failure.
- Cover abdominal eviscerations with saline-moistened sterile dressings and an occlusive barrier, and never manipulate protruding viscera or impaled objects.
- Avoid repeated pelvic compression; stabilize suspected pelvic fractures using a binder or sheet centered directly over the greater trochanters.
- Assess distal neurovascular function before and after splinting; immobilize adjacent joints for long-bone fractures and adjacent bones for joint injuries.
- Do not immerse amputated parts in water or place them directly on ice; preserve them cool in a watertight container and maintain limbs at heart level for suspected compartment syndrome.
Practice this section
Explained EMT Patient Treatment and Transport questions, no account needed. EMT Patient Treatment and Transport practice test
The full lesson continues with 3 more sections with exam tips, audio in English and Spanish, 5 Check yourself questions and 20 flashcards.
- 1 month
$50.99$25.49 - 3 months
$149.99$74.99 - Lifetime
$305.99$152.99
One payment, no subscription.
See EMT plansAlready a member? Log in
Sample lesson: Respiratory Emergencies: Distress, Failure, Asthma and COPD25 practice questions on this exam
Each EMT practice test has 25 original questions with the answers explained. No account needed.
Open the EMT practice testsOriginal lesson written for EMT practice · updated October 15, 2026. Exam names are trademarks of their owners; tests.global is not affiliated with them.