C-spine and cord trauma Flashcards Preview

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Flashcards in C-spine and cord trauma Deck (21):
1

epi of C-spine injury (CSI)

- 1 with low E
- 10% with high E
- C2 most common
- C 6 and 7 next most
- more common with GCS

2

6 causes of missed CSIs

1. head injury
2. intox
3. distracting injuries
4. need for urgent ETT
5. poor quality imaging
6/ neuro Sx due to other causes

3

what is key about blunt trauma

assume CSI
- immobilize

4

keys to immobilize

hard collar+sandbags+ tape and roll

5

what is needed to clear C-spine

- rule out bony and ligamentous injury
- can clear clincally w/out X-ray
- cannot clear with x-ray and no clinical

6

5 things needed for clincal clearance

1. N sensorium (no intox)
2. no midline spine pain/tenderness
3. no neuro Sx
4. no distracting injuries
5. painless ROM of C-spine (AFTER ruled out 1-4)

7

what happens if any of them are not met

must perform CT with 3D reconstruction

8

3 things must have even when clear on CT

1. no pain tenderness
2. no neuro Sx
3. able to move head and neck w/out pain

9

4 options if can't clear C-spine (uncons, massive head injury)

1. leave collar on until awake
2. take off and reapply when wakes up
3. dynamic flex/ext views (not done
4. MRI - not routine

10

2 general cats of cord injury

1. complete vs. incomplete
2. spinal shock vs neuro shock

11

def. complete

NO motor or sense below, refexes hyper
- will not improve

12

def. incomplete

- SOME motor/sense
- may improve

13

def. spinal shock

complete loss of all cord function below
- NO motor, sense, reflexes
- days-weeks

14

def. neurgenic shock

- hypotension
- loss of innervation T1-L2
- higher lesion, more sympathetics lost

15

2 SCI goals

1. prevent 2ndry injury
2. prevent/treat complications

16

4 ways to prevent more injury

1. immobilize
2. maintain cord perf pressure
3. avoid hyper glycemia/hyperthermia
4. ?? early surg?

17

what is important resp complication

- C3,4,5 - diaphragm
- less FEV, FVC, less cough
- atelectasis
- prolonged vent

18

4 CVS complications

1. hypotension
2. hypothermia (Can's vasoconstrict)
3. DVT
4. autonomic dysreflexia

19

what triggers autonomic dysreflexia

- full bowel or bladder
- get constriciton
- can;t cancel constriction

20

2 GI complications

1. ulcers
2. gatric atony/ileus

21

skin complications

ulcers

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