For First Responders

Now Offering Continuing Education Hours for Emergency First Responders (CAPCE)

EMS Pitfalls: Ankylosing Spondylitis

Standard EMS treatment protocols can cause injury, disability, and even death in patients with ankylosing spondylitis (AS). This course will provide tools to recognize AS, and safely and properly manage it in emergency situations.

This course offers 1.0 CEH through the CAPCE Commission on Accreditation for Pre-Hospital and can be used towards applicable recertification and license renewal.

This course provides the education and training to ensure that all emergency first responders—including emergency medical technicians, paramedics, and fire and police safety personnel—have an opportunity to learn the proper and safe techniques in the care and handling of those with AS.

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Download EMS Pitfalls Takeaway Sheet

What Do First Responders Need to Know About Ankylosing Spondylitis (AS?)

What is AS?

Ankylosing spondylitis is a form of systemic inflammatory arthritis that impacts the spine and other joints in people of all ages and populations.
In more severe cases, the spine may fuse into a single, rigid, and brittle bone that is incapable of flexion, extension, or lateral movement, and is prone to fracture.
Common signs and symptoms of AS include chronic back and neck pain and stiffness. Other joints and organs are also frequently impacted.

Why is it Important to Recognize AS?

Ankylosing spondylitis is a form of systemic inflammatory arthritis that impacts the spine and other joints in people of all ages and populations.
In more severe cases, the spine may fuse into a single, rigid, and brittle bone that is incapable of flexion, extension, or lateral movement, and is prone to fracture.
Common signs and symptoms of AS include chronic back and neck pain and stiffness. Other joints and organs are also frequently impacted.

How Do I Manage AS in an Emergency Setting?

Complete the course above for detailed and specific information, and earn CHEs! Some key points to keep in mind are below.

Assessment

Standard EMS treatment protocols can cause injury, disability, and even death in patients with AS.
AS can be impossible to recognize in a field setting.
Proper management of AS requires first responders to recognize their patient may have an increased risk for spinal fractures, and at times modify standard protocols.

Spinal Immobilization

Cervical collars (c-collars) and rigid backboards pose a significant risk to AS patients because they may cause spinal fractures and subsequent neurological damage.
Instead of using c-collars and rigid backboards, consider splinting in place using padding.
Avoid and reduce all patient manipulation.

Airway & Intubation

The manipulation of an AS patient’s airway and head during intubation may be difficult and potentially dangerous.
Do not attempt to straighten, flex, or otherwise manipulate the spine.
Attempt to maintain adequate oxygenation using A) a BVM or B) a supraglottic device.
If a definitive airway is required, consider using video laryngoscopy to reduce patient manipulation.
If the patient immediately requires a definitive airway and intubation is unlikely or potentially dangerous, consider directly proceeding to a surgical airway.