Cervical spine injuries Assessment and early management.
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Transcript of Cervical spine injuries Assessment and early management.
![Page 1: Cervical spine injuries Assessment and early management.](https://reader035.fdocuments.in/reader035/viewer/2022081421/56649e3b5503460f94b2d81d/html5/thumbnails/1.jpg)
Cervical spine injuries
Assessment and early management
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A Dismal Image
• Cord injury not treatable still
• Unpredictable outcome
• Prolonged course of treatment
• Psychosocial factors
Commonest and most devastating injury of axial skeletonCommonest and most devastating injury of axial skeleton
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Spinal cord injuries
• Constitute 2-5 % OF all blunt trauma • 40-50 cases / million • 40 % of cervical spine injuries have
cord involvement • Cost factor
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Initial management
steps• Haemodynamic
stabilization• Cervical collar• X-ray • CT scan • MRI• Steroids
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• Traction• Secondary
exam
• ICU admission • Prevention of
DVT
• Physiotherapy
Initial management steps
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Eratic practice
• Variations • Cross table xray• Unconcious pt• high resolution imaging • cost and morbidity
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Guide lines
• British trauma society working party
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immobilization
• Critera for risk• Teqnique• Spine boards• Log rolling• Transfer slides
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Special circumstances
• Neck not neutral• Unco-operative pt• Vomiting• Intubation• Transfer to another hospital
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Exclusion criteriaclinical
• Alertness• Head injury• No alcohol or drugs• No neck pain• No neurology• No distracting injury
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Plain xrays
• Ap• Lateral• open mouth• Oblique• Other views
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Ct scan
• Targeted 2-3 mm• Whole • multi slice ct
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Mri scan
• Ligaments ,disc and neural tissue • In unconciuos pts
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Dynamic studies
• Flexion and extension xrays • Or fluroscopy
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Unconcious
• In line immobilization• Mri• Dynamic • Ct
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Aalgorithm
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