![]() ![]() Spinous process projects posteriorly from the vertebral arch.Vertebral foramen align to from the vertebral canal for the spinal cord.Vertebral arch formed by Pedicles and laminae which with the vertebral body form the vertebral foramen.Vertebral body which gives the vertebrae its strength and weight bearing ability.It is associated with significant morbidity. The initial clinical assessment and, where necessary, subsequent radiological assessment, of potential cervical spine injury is the subject of this session.Ĭervical spine immobilisation is not a benign intervention. Supine immobilisation causes considerable deterioration in respiratory functionĪ large number of patients present to Emergency Departments (ED) with their necks immobilised as significant cervical spine injury is rare and there are potentially adverse consequences of cervical spine immobilisation, reliable methods are needed to clinically exclude cervical spine injury wherever possible (‘clearing their necks’).Long boards and collars cause pain and tissue ischaemia which can lead to pressure sores.Collars significantly raise intracranial pressure: an effect that is potentially significant in the presence of head injury.This means that, in patients who present to hospital with potential neck injuries, the vast majority of them will not actually subsequently be shown to have a cervical spine injury.Ĭervical spine immobilisation is not a benign procedure: In alert patients the incidence was only 2.8%, whilst those who were clinically unevaluable (because of depressed conscious level, intoxication, etc) there was a higher incidence of 7.7%. found that the overall incidence of actual cervical spine Injury was 3.7%. In a review of the literature (209,320 patients) evaluating the potential for cervical spine injury in a trauma population, Milby et al. has a history of past spinal problems, including previous spinal surgery or conditions that predispose to instability of the spine.has priapism (unconscious or exposed male).has altered or absent sensation in the hands or feet (sensory assessment).has any hand or foot weakness (motor assessment).is under the influence of drugs or alcohol. ![]() has any significant distracting injuries.23Īccording to NICE guideline, 21 on assessment, maintain In-line manual immobilisation when assessing/instrumenting the airway.Īt all stages, protect the spine and avoid moving the remainder of the spine.Īssess the person for spinal injury, initially taking into account the factors listed below. To that end, cervical spine immobilisation was previously the most commonly performed procedure in pre-hospital care. Historically Immobilisation of the cervical spine on the slightest suspicion of injury is recommended by most resuscitation courses including ALS, ATLS, APLS, PHTLS, as well as by NICE and JRCALC (National Ambulance Service Guidelines). Cervical spine injuries are rare but potentially devastating. ![]()
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