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C-spine precautions

C-spine precautions. Oct/21/2008. 18 year old girl involved in MVC, front seat passenger, no seat-belt. The car hit the traffic light at 100km/hr , gas tank exploded and fire started, extraction time was 45 minutes, no Hx. Of LOC What is your next step ?. Air way with C-spine precautions

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C-spine precautions

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  1. C-spine precautions Oct/21/2008

  2. 18 year old girl involved in MVC, front seat passenger, no seat-belt. The car hit the traffic light at 100km/hr , gas tank exploded and fire started, extraction time was 45 minutes, no Hx. Of LOC • What is your next step ?

  3. Air way with C-spine precautions • Breathing • Circulation • Disability • Exposure with environmental control • Secondary survey

  4. Missed injuries • 10% in head trauma patients • 6% in patients without head injury • Risk of disease transmission

  5. C-spine in a trauma patient • Suspect injury in all patients • Pain and tenderness, decreased LOC, injuries above the clavicle, weak Ext. or altered sensation • Careful neurological exam • Complete • Incomplete • ASIA score

  6. What to do if you suspect injury: • Hard collar and back board • Transfer with in-line manual cervical immoblization • Keeping shoulders and hips aligned at all times

  7. Neurogenic shock • Sequelae of secondary cascade of cellular dysfunction • Inflammation, edema, hemorrhage,free radicals,lipid peroxidation, electrolytes imbalance • Methylprednisone • 30mg/kg bolus, 5.4mg/kg/h infusion

  8. Noncontiguous traumatic spinal injuries in 5-20%

  9. Lateral C-Spine

  10. C-Spine Landmark • 1. Anterior arch of the atlas • 2. Dens of axis • 3. Posterior arch of the atlas • 4. Soft palate • 5. Root of the tongue • 6. Transverse process • 7. Intervertebral disc • 8. Inferior articular process • 9. Superior articular process • 10. Zygapophyseal (facet) joint • 11. Spinous process of C7

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