400 Section - The Development of Comprehensive Acute Spinal Injury Guidelines for a Major Trauma Centre: A Multidisciplinary Approach

Spinal trauma requires coordinated multidisciplinary management to reduce complications and optimise recovery. Historically, assessment and management practices have varied across acute hospitals in Ireland. To address this, Cork University Hospital (CUH), the designated Major Trauma Centre for the South Trauma Network, led by the Inpatient Trauma Service (IPTS) team, developed comprehensive Acute Spinal Injury Guidelines aimed at standardising care, reducing avoidable complications, and improving patient outcomes.

Design:

The guidelines were created by the IPTS team working alongside healthcare professionals from Emergency Medicine, Orthopaedics, Neurosurgery, Rehabilitation Medicine, Geriatrics, Intensive Care, Pain Medicine, Physiotherapy, Occupational Therapy, Speech and Language Therapy, Clinical Psychology, and Nursing. The team reviewed current literature and best-practice standards, adapting recommendations to CUH’s local trauma system. The guidelines were approved by the Major Trauma Clinical Operations Group.


Results:

The guideline provides a structured, evidence-informed approach to managing spinal trauma, including early recognition, immobilisation, imaging, and acute interventions. It outlines protocols for neurological assessment (ISNCSCI scoring), pain and respiratory management, bowel care, thromboprophylaxis, pressure ulcer prevention, nutrition, and early multidisciplinary rehabilitation. Clear timelines, documentation standards, and escalation pathways support consistent, efficient care delivery.


Conclusion:

This initiative, driven by the IPTS team, highlights the impact of collaborative multidisciplinary work in establishing unified, evidence-based guidance for complex trauma care, incorporating rehabilitation from the outset. The implementation and impact of the guidelines will continue to be audited to ensure ongoing improvement.

The guideline exemplifies how interdisciplinary collaboration can improve patient safety, streamline acute care, and support the national trauma system’s goals for equitable, high-quality rehabilitation from the onset of admission.