Secondary Assessment

Question 1

What does the ability to walk or feel sensation indicate about spinal cord injuries?

Answer 1

It does not necessarily rule out a spinal cord or spinal column injury

The absence of pain does not always indicate that a spinal injury has not occurred.

Question 2

What should you instruct a patient with a possible spinal injury to do?

Answer 2

Keep still and not to move the head or neck

Do not ask patients to move their necks as a test for pain.

Question 3

What types of examinations may be performed on patients?

Answer 3

Systematic full-body scan or systematic assessment focusing on a certain area

Often determined through the chief complaint.

Question 4

What is the recommended action for patients with moderate or severe head injuries?

Answer 4

Receive life-saving medical or surgical intervention at the closest appropriate trauma hospital without delay

If time allows, perform a secondary assessment to identify and treat missed injuries.

Question 5

How can extremities be stabilized during transport?

Answer 5

Using the backboard and splinted individually

This should be done while in the back of the ambulance as time and conditions permit.

Question 6

What is essential to obtain in patients with head and spine injuries?

Answer 6

A complete set of baseline vital signs

Significant head injuries may cause the pulse to slow and blood pressure to rise.

Question 7

What may happen to the heart rate and blood pressure in neurogenic shock?

Answer 7

Blood pressure may decrease and heart rate may increase to compensate

Respirations can become erratic with complications from head and spine injuries.

Question 8

What can hypotension indicate in relation to spinal injuries?

Answer 8

It may be present with cervical or high thoracic spine injuries

The heart rate may become slow or fail to increase in response to hypotension.

Question 9

What monitoring devices should be used for patients suspected of having a head injury?

Answer 9

Pulse oximetry and ETCO monitoring

Ensure the patient is not hypoventilating or hyperventilating.

Question 10

What are the recommended ranges for ETCO and pulse oximetry readings?

Answer 10

ETCO between 35 and 40 mm Hg and pulse oximetry above 94%

Monitor blood pressure as hypotension can decrease blood supply to the head.

Question 11

What is the recommended method for assessing a patient’s first blood pressure?

Answer 11

Manually with a sphygmomanometer and stethoscope

This is important for accurate assessment.