In Protocol 5, after Key Question 2 reveals back strain from a tackle, what should the EMD do next?

• A. Shunt to protocol 30
• B. Continue with protocol 5
• C. Reassess and end the call
• D. Shunt to protocol 18

Answer: (A)

When there’s a mechanism suggesting a potential spinal injury, the dispatcher must shift from the current protocol to the trauma/spinal injury protocol. Back strain from a tackle signals a possible spinal injury, so you move to the trauma pathway to ensure proper spine precautions, focused assessment for neuro findings, and appropriate guidance for immobilization and transport.

This escalation is essential because the original protocol isn’t designed to address spinal immobilization and trauma-specific priorities. Continuing on the initial path could miss critical steps like maintaining spine stability, monitoring for neurological changes, and preparing the patient for safe transport.

Once you switch to the trauma/spinal injury protocol, provide clear instructions to minimize movement, maintain spinal alignment if movement is unavoidable, monitor breathing and responsiveness, and arrange for prompt transport as indicated.