spinal injury recap

Question 1

can first aid provider should use immobilization and are they allow to apply cervical collar

Answer 1

no and no it’s not recommend

Question 2

after how long does patient report pain and pressure sure from being on the long backboard

Answer 2

pain: 30min
pressure sore: 1h

Question 3

what are the ITLS position with SMR

Answer 3

1. SMR is not indicated in every trauma patient
2. long spine board + other rigid device = extrication device
3. Patient should be remove from long spine board as soon as it safes
4. Maintenant of in-line spinal aligment remain important
5. SMR should be applied to patient with indicator
6. SMR is not indicated with penetrating wound of torso, head or neck unless there’s evidence of spinal

Question 4

difference between spinal and burner/stinger

Answer 4

burner/stinger: pain radiate unilaterally down the arm and hand

spinal: bilateral

Question 5

weakness and numbness from burner/stinger is associated with which nerve root

Answer 5

C5-C6

Question 6

what are the 2 type of mechanism that could result in burner/stinger

Answer 6

• Compressive mechanism head and neck moved into postero-lateral direction toward symptomatic upper limb
• Tensile mechanisme, arm and neck force in opposite direction

Question 7

how º of AROM the patient should be able to rotate without difficulty in the assessment of potential spine

Answer 7

45º

Question 8

when the spinal is highly unlikely

Answer 8

during RROM step
If all test + AROM -ve, if we are that far = spinal highly unlikely

Question 9

which skill is the best option for extrication

Answer 9

supine scoop

Question 10

which one between lof roll and supine lift & slide is better

Answer 10

supine lift and slide

Question 11

what extrication device do you use if you are in an uneven surface or in a tight space

Answer 11

supine straddle lift and slide

Question 12

which device do you use on ice and which one on turf

Answer 12

single clam: ice
double clam: turf

Question 13

which technique is useful with a heavier athlete

Answer 13

prone log roll

Question 14

T/F you may just put 3 horizontal strap for short transfer

Answer 14

T

Question 15

statistic show that Backboard immobilization over 30 min result in

Answer 15

• 100% of patient develop pain within 30min of observation
• 55% graded their pain as moderate or sever
• 29% develop additional symptome over the next 48h

Question 16

what are the high risk factors of canadien C-spine rule

Answer 16

age > 65
dangerous mechanism
parenthesis in extremity

Question 17

what are the low risk factor which allow safe assessment of ROM with canadien C-spine rule

Answer 17

• Simple rear end MVC
• Ambulatory at any time
• Delayed onset of neck pain
• Absence of midline C-spine tenderness

Question 18

what is step 3 of canadien C-spine rule

Answer 18

3. Able to actively rotate neck 45º left and right

Question 19

which type of shock occurs secondary to spinal cord injury

Answer 19

neurogenic shock

Question 20

which type of shock is associated with warm skin/dry, low pulse, low BP and hypovolemia

Answer 20

neurogenic shock

Question 21

what is neurogenic shock

Answer 21

• Lesion to vaso-regulatory fiber = produce loss of sympathetic tone to vessel below lesion

Question 22

which type of shock is usually caused by penetrating type or bony

Answer 22

spinal shock

Question 23

what is spinal shock

Answer 23

• Damage/disruption of spinal cord blood supply = local cord tissu ischemia

Question 24

which type of shock is associated with Loss of all sensory/motor fcn, paralysis
Loss of reflex below level of spinal injury

Answer 24

spinal shock

Question 25

spinal shock severity depend on what

Answer 25

amount of bleeding into tissue

Question 26

spinal X-ray criteria

Answer 26

• no posterior midline cervical spine tenderness
  - no evidence of intoxication
  - normal level of alertness
  - no focal neurologic deficit
  - no painful distracting injuries

Question 27

when can you 100% rule out spinal injury

Answer 27

• No distracting injury, no sign of spinal shock and all other test -ve

Question 28

delayed symptom of spinal injury are usually from

Answer 28

spinal cord edema, secondary hypoxia