C-spine and cord trauma Flashcards
1
Q
epi of C-spine injury (CSI)
A
- 1 with low E
- 10% with high E
- C2 most common
- C 6 and 7 next most
- more common with GCS
2
Q
6 causes of missed CSIs
A
- head injury
- intox
- distracting injuries
- need for urgent ETT
- poor quality imaging
6/ neuro Sx due to other causes
3
Q
what is key about blunt trauma
A
assume CSI
- immobilize
4
Q
keys to immobilize
A
hard collar+sandbags+ tape and roll
5
Q
what is needed to clear C-spine
A
- rule out bony and ligamentous injury
- can clear clincally w/out X-ray
- cannot clear with x-ray and no clinical
6
Q
5 things needed for clincal clearance
A
- N sensorium (no intox)
- no midline spine pain/tenderness
- no neuro Sx
- no distracting injuries
- painless ROM of C-spine (AFTER ruled out 1-4)
7
Q
what happens if any of them are not met
A
must perform CT with 3D reconstruction
8
Q
3 things must have even when clear on CT
A
- no pain tenderness
- no neuro Sx
- able to move head and neck w/out pain
9
Q
4 options if can’t clear C-spine (uncons, massive head injury)
A
- leave collar on until awake
- take off and reapply when wakes up
- dynamic flex/ext views (not done
- MRI - not routine
10
Q
2 general cats of cord injury
A
- complete vs. incomplete
2. spinal shock vs neuro shock
11
Q
def. complete
A
NO motor or sense below, refexes hyper
- will not improve
12
Q
def. incomplete
A
- SOME motor/sense
- may improve
13
Q
def. spinal shock
A
complete loss of all cord function below
- NO motor, sense, reflexes
- days-weeks
14
Q
def. neurgenic shock
A
- hypotension
- loss of innervation T1-L2
- higher lesion, more sympathetics lost
15
Q
2 SCI goals
A
- prevent 2ndry injury
2. prevent/treat complications
