It must be kept into the mind that all trauma patients are at risk for spinal injury. The principle of spinal care in all trauma patient is based on the possibility that all trauma patients may have an unstable spine injury definitively excluded.
In any trauma setting the treatment priorities are preserving life, limb, and function. The spine must be protected as these priorities are addressed.
Extrication
Proper extrication of the patient and immobilization of the cervical spine at the accident scene are critical to avoid further neurologic injury. The neck movements are to be avoided when taking out the person out of the car or shifting the person. For this, the head and neck need to be aligned with the long axis of the trunk and immobilized in this position.
Immobilization and Transport
The cervical spine needs to be immobilized to prevent further movements that can cause damage to the spinal cord. Immobilization with cervical collar, sandbags, tape, and spine board is superior to immobilization with a collar alone. For field transportation of injured patients, a scoop stretcher is is a very good adjunct. the spine is usually kept in neutral position irrespective of type of injury.
eutral flexion-extension head and neck alignment is optimal during prehospital transport of cervical spine injury patients . To maintain neutral head-neck alignment. in children, the relatively larger head of should be accommodated by elevating the trunk on padding or using a special pediatric spine board.
Helmet and shoulder gear should be left in position until personnel trained in safe removal techniques are available.
Preliminary Neurological Assessment
Determination of gross neurologic status in the field helps prioritize subsequent treatment interventions.
Following points can help in localising the injur
- Observations of the patient’s spontaneous physical movements and function
- Ask patient about site of pain
- Eliciting symptoms /signs
Communication
Suspicion of neurologic injury should be conveyed to the hospital to prepare for subsequent evaluation and management.
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