C-Spine injuries Flashcards
Fracture of bony elements, dislocations at one or more joints, tearing of ligaments, disruption of discs - force + flexion, extension, rotation, compression
Primary injury
Minutes to hours after injury - incompletely understood, ischemia, hypoxia, inflammation, edema
Secondary injury
What do you need to avoid with secondary spine injuries?
Hypotension
What do you need to take care of first with C-Spine injuries?
ABCD - airway, breathing, circulation, disability
No posterior midline cervical spine tenderness, no evidence of intoxication, normal level of alertness, no focal neurological deficits, no painful distracting injuries
NEXUS low-risk criteria – NO need for spine radiography!
Age 65 years old, dangerous mechanism of injury, paresthesias in extremeties
Canadian C-Spine rule – Perform radiography on these patients!
Will result in loss of spontaneous breathing
C4
Will result in loss of shoulder shrug
C5
Will result in loss of flexion at elbow/biceps reflex
C6
Will result in loss of extension at elbow/triceps reflex
C7
Will result in loss of flexion at fingers
C8/T1
Will result in loss of intercostal muscle and abdominal muscle use
T1/T2
70% of detectable spine abnormalities will be visible on the _____ X-ray view
Lateral
Do normal radiographs rule out significant cervical cord injury?
NO!
When should you use CT vs x-ray?
X-ray is good for “low risk” patients, CT is for “high risk” patients
