Care of Cranio-cervical Traction - Intensive Care & Coordination ...

Procedure Rationale
assessing strength and movement of all
limbs, using the Nepean Hospital
Neurological Observation Chart.
Sensory function should be assessed by
lightly pinching the patient’s skin, or
lightly dabbing with ice, starting at the
shoulder level and working down both
sides of the extremities. Record the
highest level of function on each side.
Ask the patient to close their eyes during
the examination.
If there are any major changes in the
previously mentioned observations, there
should be immediate notification of the
Neurosurgical team. If prompt
assessment by the Neurosurgeon is not
available call 42222 and ask for the
Medical Emergency Team.
Patients undergoing reduction of cervical
fracture or dislocation can usually be
lifted using a Jordan frame and lifter, with
inline traction maintained. If the traction
weight is removed then a cervical collar
should be applied, the neck immobilised
with sandbags, and manual traction
maintained by a senior medical staff or
senior registered nurse. Confirm with the
neurosurgeon if this is appropriate for the
patient.
For patients whose cervical spine is
simply being immobilised (i.e. a fracture
is not being reduced) a hard collar can be
applied, traction removed, and the patient
can be log rolled or lifted on a Jordan
frame in the standard way. Supervision
by a senior medical officer or senior
registered nurse is required. Confirm with
the neurosurgeon if this is appropriate for
the patient.
Most patients in cervical traction can be
safely log rolled without removing
traction, but alignment of head, neck and
body must be maintained. Supervision of
this alignment should be undertaken by a
senior medical officer or a senior
registered nurse. Confirm with
neurosurgeon if this is appropriate for the
Wentworth Area Health Service
Care of Cranio-cervical Traction
the traction and alignment of the neck,
leading to neurological deficit. Using the
chart standardises the assessments.
Any change could mean dislodgement of
the traction and alignment of the neck,
leading to neurological deficit.
Each side needs to be recorded, as there
may be unilateral sensory function loss.
Delay in assessing changes in a patient
with a cervical spine fracture can lead to
quadriplegia, respiratory and cardiac
arrest.
If the patient with a cervical spine fracture
is moved in an unsafe manner, damage
to the cervical spine and quadriplegia
may result.
If the patient whose cervical spine is
being immobilised is moved in an unsafe
manner, damage to the cervical spine
and quadriplegia may result.
If the patient whose cervical spine is
being immobilised, is moved in an unsafe
manner, damage to the cervical spine
and quadriplegia may result.