Spine Trauma Flashcards
Common causes of spinal injury
blunt trauma, auto accidents, preventable violence- suicide, shootings, etc.
who is typically affected by spinal injuries
young men
which portion of the spine is most vulnerable to blunt force injury
cervical spine
what should be a concern when you see someone with a thoracic injury?
organ injuries
what is the most common injury to the lumbar spine
compression fracture
what level does the spinal cord end
L1-2
4 steps in management of spinal injuries
CABs (formerly ABCs)
Immobilization
Early intubation
Transport to appropriate facility
what should you avoid when intubating someone with a spinal injury
head tilt chin lift
what 3 things are used to immobilize a potential cervical injury
rigid collar
support blocks
backboard with strap
what exam should you do when splinting someone with a spinal injury?
when should you do it?
test for motor and sensory deficits in all extremities
test before and after splinting
What are you palpating for during a spine exam
step-offs and tenderness
what portion of the exam must you not skip!!!
rectal exam- tone, sensation, contraction
what normal finding is typically absent with spinal cord injury?
reflexes
what are the levels in ASIA scoring
A - E with A being complete loss of motor and sensory function to E being normal motor and sensory function
what is the NEXUS criteria
National Emergency X-Radiography Utilization Study
clinical criteria for when CTs or X-rays are indicated
when should a cervical CT be ordered per NEXUS?
5 criteria
midline cervical tenderness focal neuro deficit if patient is not alert intoxication painful, distracting injury
what kinds of cervical spine fractures require a surgical consult
ALL of them!
when does a thoracic or lumbar spine fracture require a surgical consult
surgery not always necessary- depends on the stability of the fracture and the neurologic status of the patient
what is the most common fracture seen in patients with osteoporosis or chronic steroid use?
compression fracture (wedge fracture)
where should you refer all patients with a spine injury, regardless of whether it’s surgical?
rehab- early as possible
PT and OT
For which patients should you be on high alert if they present with spine pain?
Ankylosing Spondylitis
osteoporosis
chronic steroid use
