How Do You Evaluate Cervical Spine Injury?

If the nominated decision rule indicates high risk of injury, cervical spine imaging is indicated. An accurate history, physical examination and radiographic screening are required, preferably with

computed tomography imaging

, or five-view plain X-ray if computed tomography is unavailable.

How do you assess a patient with a spinal injury?

Perform an X-ray

as the first-line investigation for people with suspected spinal column injury without abnormal neurological signs or symptoms in the thoracic or lumbosacral regions (T1–L3). Perform CT if the X-ray is abnormal or there are clinical signs or symptoms of a spinal column injury.

What are the signs and symptoms of a cervical spine injury?

• Extreme back pain or pressure in your neck, head or back.
• Weakness, incoordination or paralysis in any part of your body.
• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes.
• Loss of bladder or bowel control.
• Difficulty with balance and walking.

What do you do if you suspect a back or neck injury?

1. Get help. Call 911 or emergency medical help.
2. Keep the person still. …
3. Avoid moving the head or neck. …
4. Keep helmet on. …
5. Don’t roll alone.

What are the five parts of the focused spine assessment?

There are five commonly used protocols for ruling out possible spine injuries in the field:

the Canadian C-spine Rule (CCR), the National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria (NEXUS), the modified Nexus criteria, the State of Maine criteria (also based on the NEXUS criteria), and the

…

How do you perform a spinal test?

1. Palpate each spinous process for tenderness. Start with the atlanto-occipital joint and finishing at the sacroiliac joint.
2. Palpate the trapezius and paraspinal muscles, assessing for muscle bulk, spasm and tenderness.
3. Gently percuss down the spine for pain or tenderness. …
4. Feel for temperature down the spine.

What is the most important step in an injury assessment?

Identifying the history of the injury

can be the most important step of injury assessment. A com- plete history includes information regarding the primary complaint, cause or mechanism of the injury, characteristics of the symptoms, and any related medical history that may have a bearing on the specific condition.

How do you check sensory levels?

Sensory level: The sensory level is determined by

performing an examination of the key sensory points within each of the 28 dermatomes on each side of the body (right and left)

and is the most caudal, normally innervated dermatome for both pin prick (sharp/dull discrimination) and light touch sensation.

Which of the following should you always suspect of having a head neck or spinal injury?

A head or spinal injury should be suspected if the mechanism of

injury suggests an impact or blunt force to the head, neck or back

. If a person appears to have a head injury, you should also suspect a spinal injury and vice versa.

What is a cervical spine injury?

Cervical spinal cord injuries are

the most severe of all spinal cord injuries

and may affect one or both sides of the body. The higher up in the spine that the injury occurs, the more severe the potential outcome. Some cervical spinal cord injuries are severe enough to result in death.

How do you know if you have a spinal injury?

1. problems walking.
2. loss of control of the bladder or bowels.
3. inability to move the arms or legs.
4. feelings of spreading numbness or tingling in the extremities.
5. unconsciousness.
6. headache.
7. pain, pressure, and stiffness in the back or neck area.
8. signs of shock.

What is a focused spine assessment?

The focused spine assessment, our system for assessing the spine at NOLS, is

an intentional, careful, evidence-based assessment

. We seek the inconspicuous spine injury by checking twice for patient reliability, abnormal CSM’s, and spine pain or tenderness.

What is the most important indicator of a possible spinal injury?

Signs and symptoms

A spinal injury should be suspected if the patient has:

pain at or below site of injury

.

loss of sensation

, or abnormal sensation such as tingling in hands or feet. loss of movement or impaired movement below site of injury.

How do you assess spinal cord compression?

1. X-rays of your spine. These may show bone growths called spurs that push against spinal nerves. …
2. Special imaging tests of your spine. A CT or MRI scan will give a more detailed look at the spinal cord and the structures surrounding it.
3. Other studies.

What is Brown Séquard syndrome?

Brown-Séquard syndrome is

a rare spinal disorder that results from an injury to one side of the spinal cord in which the spinal cord is damaged but is not severed completely

. It is usually caused by an injury to the spine in the region of the neck or back.

How do you assess a back injury after a fall?

1. pain or tenderness (sore to touch)
2. pain that worsens with movement, coughing, sneezing or laughing.
3. stiffness or difficulty moving.
4. difficulty standing up straight.
5. muscles in spasm on either side of the spine.
6. bruising.
7. swelling.
8. pain that radiates down one or both legs.

What is a myelogram test?

A myelogram is

a diagnostic imaging test generally done by a radiologist

. It uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. Problems can develop in the spinal cord, nerve roots, and other tissues. This test is also called myelography.

What are the four components of the injury assessment?

A physical examination has four components:

inspection, palpation, percussion, and auscultation

(Fig. 2-1). Inspection involves a close examination of the injured area looking for deformity, contusions, abrasions, swelling, and bleeding.

What is an injury assessment?

An injury/illness evaluation helps

to determine the extent and nature of a health issue

, necessary or recommended medical treatment(s) and referral(s), a proper rehabilitation protocol, return to play, verification for medical insurance and payment, and documentation of the frequency of health issues.

What are the 4 steps of an injury evaluation?

• Phase I Injury Planning. …
• Phase II Injury Occurrence. …
• Phase III Injury Evaluation. …
• Phase IV Injury Treatment.

What is the Asia test?

This is

a system of tests used to define and describe the extent and severity of a patient’s spinal cord injury and help determine future rehabilitation and recovery needs

. It is ideally completed within 72 hours after the initial injury.

What is Asia assessment?

What is the ASIA Impairment Scale? The American Spinal Injury Association Impairment Scale is

a standardized neurological examination used by the rehabilitation team to assess the sensory and motor levels which were affected by the spinal cord injury

.

What is included in a sensory assessment?

A Sensory assessment would consist of

assessing how your child copes with the ever growing load of sensory information that enters their senses on a daily basis

. Through analysis of the behaviours the child demonstrates under stress the therapist can help deduce why they may be misbehaving.

Which method should be used to check the breathing of a casualty with cervical injury?

To check if they are breathing, put your cheek above their mouth and nose; look down their body,

listen to their breathing and feel their breath on your cheek

. Keep supporting their head and neck.

When the signs and symptoms of a spinal nerve damage are present in a victim?

• Numbness, tingling, or a loss of or changes in sensation in the hands and feet.
• Paralysis that may happen immediately or develop over time as swelling and bleeding affects the spinal cord.
• Pain or pressure in head, neck, or back.
• Loss of movement.

When should you perform a secondary assessment?

It should be performed

after the primary survey and the initial stabilization is complete

. The purpose of the secondary survey is to obtain pertinent historical data about the patient and his or her injury, as well as to evaluate and treat injuries not found during the primary survey.

What is Nexus criteria?

Clears patients from cervical spine fracture clinically, without imaging. The NEXUS Criteria represent a

well-validated clinical decision aid

that can be used to safely rule out cervical spine injury in alert, stable trauma patients without the need to obtain radiographic images.

When should you suspect cervical spine injury?

Spinal cord injury should be suspected

in unconscious patients

, or in patients with axial neck pain or those with evidence of neurological injury. Beware that absence of neurologic findings does not eliminate the possibility of spinal cord injury. Physical examination should include a detailed neurological examination.

What are the six questions you should answer when checking the scene?

• Is the scene safe?
• What happened?
• How many victims are there?
• Are bystanders available to help?