So we've looked at airway, breathing, circulation.
Now we're down to the D, for disability. So always thinking about the neurologic status and not extending the injury.
So, we wanna make sure, until you know what the status is of that spinal cord.
In the patients brought into ER, they're gonna have to figure out,
"Does the patient have a spinal cord injury or not?"
So until they can rule that out, they keep the neck immobilized.
Now, you'll read, there's a lot of controversy row,
"What should we use? Shall we use collars or not?"
So there's a lot of discussion going on about that.
But, our idea is - the goal here is that we wanna keep that patient in a neutral place.
So whatever the policy is in your area, in your hospital, a lot of times it's a cervical collar.
You wanna make sure that you keep that neck in a neutral place.
Athletic headgear. If this happened on an athletic event,
and let's say happened at a football game and the athlete is wearing a helmet, leave the helmet on, don't take it off.
Because remember, the goal is, a neutral position of the neck, whatever it takes to get them in that.
So, we talked about airway, breathing, circulation and disability, neurologic status.
Remember, if a spinal cord injury is suspected, you wanna do everything you can to protect that spinal cord
and keep it in a neutral position until it can be ruled out in an emergency setting.
Now we're gonna look at how that injury is actually ruled out.
Many trauma patients have cervical spine imaging to rule out traumatic spinal cord injury.
So let's talk about what the imaging studies are.
You might do - see them do a cervical x-ray.
After they do a neuro assessment and they're concerned about a possible injury,
I can now begin a really rapid assessment of alignment and fractures and if there's some soft tissue swelling.
So, cervical x-ray maybe the first thing they do. CAT scan,
depending on how quickly they can get there will show bone damage.
And an MRI; magnetic resonance imaging;
after the spine is stabilized might show the extent of the spinal cord damage.
So these are three very common tests; cervical x-rays, CAT scan and MRI.
Remember when you're taking a patient to MRI,
no metal, not for you or for the patient because the M stands for magnetic.