Emergency Care of Cervical Spinal Injuries Flashcards
(17 cards)
Vertebrae levels:
7 Cervical
12 Thoracic
5 Lumbar
Sacrum
Coccyx
Spinal Cord & Nerve Roots:
Protected by the vertebral column
Spinal Column & Cord Injury
Primary Injury:
Immediate trauma:
Compression
Stretching
Laceration / Transection
Fracture fragments
Vertebral dislocation or subluxation
Spinal Column & Cord Injury
Secondary Injury:
Progressive effects post-injury:
Ischemia
Hemorrhage
Contusion
Compression
Emergency Cervical Injury Res
Determine if unconscious or conscious
Mechanism: Axial load is the major concern (e.g., “spearing”)
Acute Cervical Injuries
Sx:
Change in level of consciousness
Neuro signs (myotomes/dermatomes, bilateral or unilateral)
Unwillingness to move
Bony tenderness, cervical muscle spasm
Vital sign deterioration
Acute Cervical Injuries
Rx:
Activate EMS
Spinal Motion Restriction (SMR)
Maintain airway and ABCs
Treat for shock, stroke, or severe bleeding if present
Axial Loading
force transmitted along the axis of the spine—usually from a head-first impact
It’s the leading mechanism of catastrophic cervical spine injuries in contact sports, especially football.
Spearing
leading with the crown of the helmet during a tackle or block
This is prohibited by most sports rules because of its high injury risk
NATA & “Heads Up” Recommendations
Heads-up tackling technique
Maintaining cervical lordosis (natural curve)
Avoiding head-down contact
Ensuring proper helmet fit and neck strengthening
Spine Injury Extraction Techniques
Cervical collar
Log-roll or 6+ person lift
Always maintain spinal alignment
Emergency Moves (if necessary)
Use only if:
Scene is dangerous
You need to gain access
Must provide care elsewhere
Lifting Techniques
Tighten abs
Bend at the hips, not the waist
Keep back straight
Shoulders square - do not twist your body!
Keep patient/object as close to the body as possible
Know own physical abilities and limitations
Ask for assistance!
Transfer Techniques:
Walking assist
Two-person seat carry
Clothes drag
Blanket drag
Ankle/foot drag
Shoulder drag
Pack-strap carry
Sports Equipment Considerations
Football and other helmeted sports:
Leave helmet/pads in place unless airway is compromised
Catastrophic spinal injuries tracked in NCCSIR reports
High school + college = most reported cases
Football has the highest risk across all levels
Catastrophic is divided into the following three definitions:
1.Fatality
2.Non-Fatal - permanent severe functional disability.
3.Serious - no permanent functional disability but severe injury. An example would be fractured cervical vertebra with no paralysis.
