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Spinal Trauma

Head and Spinal Trauma

Spinal Trauma: work to preserve as much function as possible for the patient. Always care for the patient as if the injury is unstable. Trauma affects vertebrae, ligaments, intervertebral disks and the spinal cord.

Mechanisms of Injury:

  • Compression: force directed along axis of spine. Fall on feet, head hit
  • Hyperextension: head force backwards violently> tears of ligaments and vertebral instability
  • Hyperflexion: spinal structures flexed violently downward> tears ligaments of posterior spine. Wedge fractures or V-shaped compression fractures
  • Rotation: dislocation of vertebral joints (usually in combination with flexion)

Whiplash= hyperflexion and then hyperextension

Assessment:

  • Mechanism of injury (MVA, diving, falls greater than 15 feet, GSW, Pain)
  • Deformity
  • Paralysis
  • Unexplained shock >>> spinal shock/neurogenic shock resulting from complete transection of the
    spinal cord >>> loss of vascular control

Treatment:

  • Immobilize c-spine as per protocol.
  • Airway
  • High concentration O2
  • One or two large-bore IV lines of normal saline/LR en route

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