Poorly fitting cervical collars are at best uncomfortable for patients, but may also be ineffective at cervical immobilization, can cause skin breakdown, and may even elevate intracranial pressure. These are difficult to diagnose as X-ray and CT scans are unable to directly detect them.įor instances when there may be a delay in imaging or if the prehospital cervical collar is poorly fitting, consider swapping the prehospital cervical collar, which is generally harder and less comfortable for patients, to a more long-term cervical collar, Role in stabilizing the cervical spine, and ligamentous injury can cause an unstable cervical spine. It is estimated that around 1-2% of patients presenting afterīlunt trauma will have some type of cervical spine fracture, making it of paramount importance in identifying these injuries since failure to recognize a fracture can worsen morbidity and mortality. Ligaments of the cervical spine play an important The two main causes of an unstable cervical spine injury are:Ĭervical spine fractures encompass a broad array of injury patterns, creating a spectrum of morbidity from benign yet painful conditions to permanent disability and death. Which can result in neurologic injury including paralysis if not immobilized and treated appropriately. One of the most feared causes of neck pain in the trauma patient is an unstable cervical spine injury, Neck pain is a common occurrence in the trauma patient, and as Emergency Medicine clinicians, it is our role to identify serious pathologies. Describe indications for further diagnostic imaging of the cervical spine.Describe the next steps after a cervical spine fracture is discovered on imaging.Understand the best imaging modality to evaluate for cervical spine fractures.Describe the clinical decision rules to determine the indication for cervical spine imaging in the emergency department.Your suspicion for a cervical spine fracture is low, but you wonder if you still have to obtain imaging since he has cervical spine bony tenderness.īy the end of this module, the you will be able to: On exam, his vital signs are reassuring, he is neurologically intact and not intoxicated, and has diffuse but mild midline cervical spine Loss of consciousness, was able to walk immediately after the accident, and is only complaining of neck pain. He was a restrained driver on a residential street when the car in front of him suddenly stopped, causing him to strike their rear bumper. Written by: Steven Lindsey, MD, Emory University Department of Emergency MedicineĮditor: Navdeep Sekhon, MD, Baylor College of MedicineĪ 32 year-old man presents to the Emergency Department after being involved in a motor vehicle accident. SAEMF/CDEM Innovations in Undergraduate Emergency Medicine Education GrantĬareer Development and Mentorship CommitteeĬDEM Medical Education Fellow Travel Scholarship Virtual Rotation and Educational ResourcesĮMF/SAEMF Medical Student Research Training Grant Visit us on Twitter LinkedIn Facebook YouTube Instagram
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