Cervical spine fractures Flashcards
what kind of injuries are usually associated with cervical spine(c-spine) injuries
high energy injuries(eg RTA or fall from height), also may be associated with head injury
how may dangerous and unstable cervical spine fractures be missed in patients and what can this lead to
if patient is unconscious or confused can be missed, can lead to spinal cord injury
what is used in the A part of ABCD initial management of suspected c-spine injuries
secure head with a hard collar and sand bags or blocks on a spinal board
what is included in the criteria needed to clinically clear someone of c-spine injury, all criteria must be met (6)
no history loss of consciousness, GCS 15 with no alcohol intoxication, no significant distracting injury, no neurological symptoms in limbs, no midline tenderness in palpation of c-spine, no pain on gentle active neck movement
what has to happen before the c-spine collar ca be removed from a patient
in a conscious and co-operative patient, through careful clinical assessment known as “clinically clearing” the c-spine
what imaging is used if needed to radiologically clear a c-spine injury
X-rays(AP, lateral +/- open mouth view) and CT of c-spine
what initial management is required for any suspected c-spine injuries
full trauma assessment ABCD and full neurological examination
what is involved in the neurological assessment of a c-spine injury
peripheral motor sensation, coarse touch sensation, upper + lower limb reflexes, cranial nerve evaluation, rectal exam, bulbocavernous relfex
how can more stable c-spine injuries be treated
in a firm cervical collar
what treatments can be used to treat unstable c-spine injuries
immobilisation in a ‘halo vest’, or surgical stabilisation including fusions, wiring or internal fixation
describe what a ‘halo vest’ is
type of external fixator with 4 pins into the skull
