C-Spine Trauma

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 2 October 2016

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

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Summary

Step 1: Protect the Spine Apply cervical collar Step 2: Apply NEXUS Criteria Use the “SPINE” mnemonic Spinal midline tenderness Painful distracting injury Intoxication Neurologic deficit Encephalopathy Step 3: If Patient Has None of the NEXUS Criteria… You Are Done! Step 4: If Patient Has Positive NEXUS Criteria… Obtain CT scan of the cervical scan […]

Transcript

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0:00.0	Hello, med students. My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship Podcast.
0:09.8	Today we're continuing our trauma series. We've covered head, we've covered face. Now imagine yourself in the ED, enjoying your shift, working alongside me when we get presented this case.
0:26.6	Hey, Dr. Olson. So this is James. He's a 19-year-old male. He was at a pool party, dove into the shallow end.
0:38.3	He was pulled out and ceased by an up to the EMT who was at the party.
0:43.3	He is complaining of pain and stiffness to his neck area.
0:47.3	So he went ahead and immobilized.
0:49.3	He's been A&O times 3 the whole time.
0:51.3	No LOC.
0:53.3	He's a little tacky but otherwise vials have been normal. No meds, no allergies, and no history. Mom and Dad are in the room for about two hours away. Okay. Yeah, watch your wire. Yeah, okay.
1:16.9	Neck injury, specifically C-spine injury.
1:21.0	Remember with ATLS, airway?
1:23.4	Remember, it's airway and C-spine.
1:28.0	You fail ATLS when you miss C-S-S-S-Pine.
1:31.7	This episode is really important.
1:34.0	The most important thing I want you to remember
1:36.9	is something called the Nexus criteria,
1:41.5	N-E-X-U-S.
1:49.8	The Nexus criteria is by far the most important aspect of this episode.
1:55.9	The way it works is when somebody passes the nexus criteria, you do not have to get imaging of their cervical spine during a trauma. So it saves money, it saves radiation, it saves time, it's a big deal.
2:02.4	More on Nexus and a bit. But first, let's get started with our approach.
2:08.4	First step, ATLS, you should know this. You put on a cervical collar. Airway and C spine,
2:15.8	airway and C spine, airway and C spine.-T-L-S if you forget C-spine.
	...

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