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Neck & Back injuries. Physiology. 33 in total. Physiology. C3-5 keep the diaphragm alive T attach to ribs (stronger) Which is weakest? (C? T? L?) Weakest during side-to-side movement. Pathophysiology. Mechanism Of Injury (speed/force, direction)

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Physiology
Physiology

33 in total


Physiology1
Physiology

C3-5 keep the diaphragm alive

T attach to ribs (stronger)

Which is weakest? (C? T? L?)

Weakest during side-to-side movement


Pathophysiology
Pathophysiology

Mechanism Of Injury (speed/force, direction)

Get as much info as possible! (Bystanders?) – pass onto crew

Examples?

Lateral forces more damaging

Common injury sites: C1/2, C7/T1, T12/L1

50% to cervical region


Assessment primary survey
Assessment (Primary Survey!!)

Danger – traffic, people, animals

Response – AVPU (think about where you stand when talking)

Summon help

Airway (& C-spine)

Breathing

Circulation

Dysfunction

Exposure


A irway c spine
Airway (& C-spine)

To immobilise or not to immobilise

If M.O.I suggests immobilise, do it.


A irway c spine immobilised
Airway (& C-spine) - Immobilised

  • Neutral alignment (adults / children)

  • What if there’s pain / resistance?

  • Jaw thrust (2 movements) – why?

    • (Avoid causing axial pressure)

  • What if jaw thrust doesn’t work??


Breathing
Breathing

Are they breathing??

Rate, ease, depth, regularity (might be affected by spinal cord injury)


Circulation
Circulation

Neurogenic shock → slow pulse & low BP

Changes in skin colour


D ysfunction assessment
Dysfunction: Assessment

  • Pain

  • Tenderness

  • Irregularity

  • Sensation

  • Parasthesia?

  • Movement

  • Odd sensations

Keep Pt calm!!

Look

Feel

(Move)



Management
Management

25% of spinal cord injuries result from improper handling after injury

DRS A,B

999!

LOG ROLL – why/when?

Reassure

Obs / mental status (beyond AVPU)


A irway c spine1
Airway (& C-spine)

To immobilise or not to immobilise? What influences this?


C spine clearing protocols yas
C-spineClearing Protocols (YAS)

  • Decreased consciousness (GCS <15)?

  • L.O.C?

  • Neurological S&S (tingling, numbness…)?

  • SIGNIFICANT neck/back pain?

  • Deformity, swelling, tenderness?

  • SIGNIFICANT pain on moving neck/back?

  • Drink/drugs (inc. prescribed)?

  • Other painfull (distracting) injuries?

Normal mental status

No neurological deficit

No spinal pain / tenderness

No evidence of intoxication

No extremity injury

If in doubt, immobilise !!

If M.O.I suggests spinal injury…

IMMOBILISE



If you re bored
If you’re bored…

http://www2.warwick.ac.uk/fac/med/research/hsri/emergencycare/prehospitalcare/jrcalcstakeholderwebsite/guidelines/clinical_guidelines_2006.pdf


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