Paediatric Spinal Injury Flashcards
What is a potential cause of spinal cord injury (SCI)?
Any MOI or traumatic injury.
what is the Mx If the major trauma criteria is met after blunt force trauma to the head or trunk or neurological deficits? (5)
- spinal immobilisation
- extricate on combi-carrier if necessary
- consider thoracic elevation
- consider prophylactic antiemetic
- Tx without delay as per trauma triage
Where should you tx patients who met major trauma or neurological deficits?
Tx without delay to the highest level of trauma service within 60 mins
What increases injury risk in trauma?
Hx vertebral disease / abnormalities and high risk conditions.
What factors make assessment difficult? (4)
1.Altered conscious state
2. intoxication
3. significant distracting injury
4. developmentally unable to engage in assessment.
What is the management for isolated spinal cord injury?
Nasal capnography if appropriate for age
What are signs of structural injury?
Midline pain / tenderness on palpation
Management of all other suspected SCI that does not meet major trauma guidelines? (6)
1.Spinal immobilisation
2. extricate on combi-carrier if necessary
3. consider self-extrication if patient is:
- conscious and co-operative
- not intoxicated
- not prevented by injury
- developmentally able
- immobilise on stretcher
- consider thoracic elevation
- consider prophylactic antiemetic.
Signs of reduced neck range of motion
- unable to rotate neck 45° left and right
- traumatic torticollis
- uses hand to support head or neck.
Care objectives: spinal cord injury
- Identify patients with spinal cord injury and tx them to appropriate facility
- To protect and support the integrity of the spinal column where SCI suspected or unstable vertebral injury cannot be excluded
- To avoid unnecessary spinal immobilisation by clinically excluding patients without injury to the spinal column
