Spinal Injury (Paed)

Question 1

Recite the CPG for Spinal Injury

Answer 1

Question 2

What are some secondary surveys for spinal injury?

Answer 2

• NEXUS
• NSAID
• neurologic defecit
• spinal tenderness
• ACS
• intoxication
• distracting injury
• Neurological examination
• DOLOR
• AEIOUTIPS

Question 3

What are some care objectives for spinal injuries?

Answer 3

• Identify patients with suspected SCI and transfer them to the appropriate facility
• To protect and support the integrity of the spinal column where SCI is suspected or unstable vertebral injury cannot be excluded
• To avoid unnecessary immobilisation by clinically excluding patients without injury to the spinal column

Question 4

What are the indications for ondansetron?

Answer 4

Question 5

What are the contraindications for ondansetron?

Answer 5

Question 6

What are the precautions for ondansetron?

Answer 6

Question 7

What are the side effects of ondansetron?

Answer 7

Question 8

Why do we use ondansetron in a spinal injury?

Answer 8

Prophylactically
* movement in transport
* assist with maintaining spinal precautions
* maintain airway > risk of aspiration

Question 9

Does the O2 therapy guideline apply to this presentation?

Answer 9

• YES - under “specific injuries”

Question 10

Are there any relevant CWI’s?

Answer 10

• Soft cervical collar
• Manual in-line stabilisation
• Log roll

Question 11

What are 3 differential diagnoses?

Answer 11

• SCI
• Neck pain
• Back pain

Question 12

What are some care pathways/treatment options to consider?

Answer 12

• Reassurance
• Spinal immobilisation
• Consider self-extrication if patient is
• Conscious and cooperative
• Not intoxicated
• Not prevented by injury
• Developmentally able
• Immobilise on stretcher
• Consider thoracic elevation
• Consider prophylactic antiemetic
• Nasal capnography
• Reassessment

Question 13

What are some extrication considerations?

Answer 13

• Combi-carrier
• Spinal immobilisation
• Collar
• Consider thoracic elevation

Question 14

As per Major Trauma CPG, list 2 care objectives

Answer 14

Immediate control of major haemorrhage
Ensure
* Airway patency
* Breathing (adequate oxygenation and ventilation)
* Circulation (adequate perfusion for the patients presentation)
Prioritise transport
Supportive care as required

Question 15

What are some secondary surveys for spinal injury?

Answer 15

• NEXUS criteria

Question 16

What are some SCI and major trauma considerations?

Answer 16

Question 17

Spinal Clearance

Answer 17

Question 18

Whats included in a neurological examination?

Answer 18

Question 19

What are the indications for a soft collar

Answer 19

Question 20

What are the contraindications for a soft collar

Answer 20

Question 21

What are the precautions for a soft collar

Answer 21

Question 22

What are the indications for MILS

Answer 22

Question 23

What are the contraindications for MILS

Answer 23

Question 24

What are the precautions for MILS

Answer 24

Question 25

What are the indications for a log roll

Answer 25

Question 26

What are the contraindications for a log roll

Answer 26

Question 27

What are the precautions for a log roll

Answer 27

Question 28

What are some management options for suspected SCI?

Answer 28

* Spinal immobilisation * Extricate on combi-carrier if necessary * consider thoracic elevation * Consider prophylactic antiemetic * nasal capnography (if appropriate for age) | Ondansetron ODT - small child (1-4 yrs) 2mg - medium child + (5 yrs +)