C-Spine Clearance Flashcards
What is the most common cause of spinal injuries
blunt force trauma
What is the most commonly injured segment of the spine
cervical
What is the order of working on a patient in an accident
ABC immobilize
When do you immobilize a neck
neck pain weakness paresthesias paralysis altered level of consciousness
What are components of spinal immobilization
long spine board semi-rigid cervical collar sandbags or other devices to limit head and neck motion
What do cervical collars not do well
limit rotation
What is important to have in place when immobilizing a neck
have a person in charge of managing the head and neck to limit movement
What is “clinical” clearance
determination if imaging required to allow removal of cervical collar
What is NEXUS criteria
1 No posterior midline cervical tenderness 2 normal level of alertness 3 no focal neruological deficits 4 no painful distracting injuries 5 no intoxication/high
What is canadian c-spine rule
normal level of alertness on Glasgow coma scale stable condition dangerous mechanism for injury
What are studies for imaging cervical spine
Plain film xray CT MRI
What does a standard plain film series consist of for c-spine clearance
AP Lateral odontoid
What is the best film view for detecting trauma in c-spine clearance
Lateral
What should be included in a lateral x-ray for c-spine clearance
C1-T1
What points should be found on a lateral x-ray for c-spine clearance
posterior cervical line
anterior longitudinal ligament line
posterior longitudinal ligament line
spina-laminar line
spinous process line
What is the pre-dental space on a plain film
atlantodental inverval 3 mm adult 5 mm child
What indicates an injury to the spine with lateral soft tissue on a plain film
>7 mm at C2 > 21 mm at C6
What are the 3 types of odontoid fracture
Type I Type II Type III
What is a Type I odontoid fracture
avulsion fracture of dens
What is a Type II odontoid fracture
fracture of dens at base
What is a Type III odontoid fracture
fracture through larger mass of C2
When is a CT indicated with c-spine clearance
any major fracture or dislocation of the spine occult fracture
When is MRI indicated with c-spine clearance
soft-tissue injury neurological deficits
Clay-shovelers fracture
