Spinal Injury (Paed) Flashcards
(15 cards)
Recite the Spinal Injury Paed CPG
Recite Neurological and Neck ROM assessment
What are the key features indicating a patient has a suspected spinal cord injury (SCI) from major trauma?
Blunt force trauma to the head or trunk, presence of neurological deficit or changes, major trauma criteria met
Major trauma criteria include specific mechanisms of injury and physiological parameters indicating severe injury.
What immediate actions are required for patients with major trauma and/or neurological deficits?
Spinal immobilisation, extrication on a combi-carrier if needed, consider thoracic elevation and prophylactic antiemetic, and treat as per CPG P0105 Trauma Triage
CPG P0105 refers to Clinical Practice Guidelines for trauma management.
How is isolated SCI managed in hypotensive patients?
Administer Normal Saline IV 10 mL/kg (max 500 mL), and Atropine 20 mcg/kg IV (max 600 mcg) if bradycardia is present
Hypotension in SCI patients can complicate management and requires prompt fluid resuscitation and potential medication.
What increases injury risk in spinal trauma assessment?
History of vertebral disease or abnormalities and high-risk conditions (e.g. age ≥ 65)
Older adults have a higher risk of sustaining significant injuries from minor trauma.
What factors make assessment difficult?
Altered consciousness, intoxication, significant distracting injury, or developmental inability to engage
These factors can mask or complicate the presentation of spinal injuries.
What clinical findings suggest structural spinal injury?
Midline pain/tenderness and reduced neck range of motion (unable to rotate 45° L/R, torticollis, holding head/neck)
Midline tenderness is a classic sign of possible spinal injury.
What should be done if any concerning findings are present?
Spinal immobilisation, extrication on combi-carrier, or self-extrication if safe. Consider thoracic elevation and prophylactic antiemetic
Ensuring the patient’s safety and stabilization is crucial in the presence of concerning findings.
What motor function tests are used for spinal assessment?
Arms: grasp / pull / push; Legs: push, plantar flex, pull, dorsiflex, leg raise
These tests help assess the integrity of motor pathways in the spinal cord.
How is sensory function tested?
Arms: light touch across palm and back of hand (C6–8); Legs: light touch lateral calcaneus (S1)
Sensory testing helps identify areas of sensory loss which may indicate specific spinal cord or nerve root injuries.
What are red flags in neurological exam for spinal clearance?
Weakness, numbness, tingling, altered sensations, or loss of sensation in areas tested
These symptoms can indicate significant neurological compromise and require further evaluation.
How should strength be compared?
Test left and right simultaneously
This ensures an accurate comparison of strength and helps identify unilateral deficits.
How do you test neck range of motion for spinal clearance?
Ask the patient to turn their head slowly left and right (~45°), stopping if pain or resistance is felt
This method allows for assessment without causing additional injury.
What is a critical instruction for neck motion testing?
Do not turn the patient’s head for them
Patient-initiated movement minimizes the risk of exacerbating an injury.
