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Spinal Injuries
| Question | Answer |
|---|---|
| How many vertebrae are in the spinal column? | 33. |
| How many vertebrae are in each section? | 7 Cervical, 12 Thoracic, 5 Lumbar, 5 Sacrum and 3-5 Coccyx |
| Types of spinal injuries? | Compression, distraction, rotation, penetration, flexion and hyperextension |
| When coming up to a patient what should you be looking for in regards to delicate spine? | Clues as to the mechanism of injury? Did anyone see what happened to them? |
| What does SMR stand for? | Spinal Motion Restriction |
| What steps should you take and what order should you move someone when doing SMR? | C-spine hold, towel + wrap legs, collar, clamshell, foam + straps, cot |
| What are the C1 and C2 vertebrae called and what is unique about them? | Axis and atlas, respectively. They are uniquely suited for rotational movement of the skull. |
| When is a good time to RBS the back? | RBS the back if the patient is face down or when you are rolling them if face up. |
| Which way do the head rolls go? | Flat foam side up, behind the head. |
| What type of injury is whiplash? | Hyperextension and hyperflexion of the cervical spine. |
| How many people are needed to remove a helmet? | Two people |
| Should you move the head to anatomical neutral when doing c-spine if it causes the patient pain? | No, use a sam splint to form a diy c-collar to support the head. |
| How can you rule out a spinal injury? | No signs of trauma, ask them if they fell or hit their head. How did they get down to the ground? (Eg. lowered themselves or did someone see what happened to them?) |
| Do gunshots warrant SMR? | Yes. The bullets could have damaged the spine. |
| Do stab wounds warrant SMR? | Yes and no. Start with it on, rule it out if the knife was short. |
| What are the 5 modified NEXUS questions? What if the answer is no to all five questions? | 1. Is there midline tenderness? 2. Is there an altered LOC? 3. Are there new focal neurological deficits? 4. Are they intoxicated? 5. Is there a major distracting injury? (Interferes with pain response?) No = SMR is not warranted. |
| What is the definition of multi-trauma? | More than one simultaneous injury, such as multiple bones fractures, major lacerations and damage to internal organ or blood vessels. |
| How do you determine the need for SMR? | By MOI and Nexus criteria |
| What is simple SMR? When would you do it? | Cervical collar on - head not taped; patient on mattress not clamshell; head of stretcher up 30 deg. only if head injured. You would do it on non-multi-trauma patients meeting NEXUS or high risk criteria. |
| What are high risk groups for spinal injuries? | Older than 65 Osteoporosis Pre-existing spinal condition |
| What criteria is included in potential thoracolumbar injuries? | Dangerous mechanism of injury Fall from height>3m Axial load to head or base of spine High speed MVI (>100) Rollover MVI Pre-existing spinal pathology New back deformity, bruising or bony midline tenderness on logroll |
| If a patient has met criteria for a T/L injury, but does not need SMR per Nexus, what should you do? | Do not sit the patient up or raise the head of the stretcher |
Created by:
Levelstorm3950