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C-spine clearance (Complications of delayed clearance (Increased risk of…
C-spine clearance
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Management
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Mild C-spine injury
Early active range of movement, indications: whip lash injury
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Examination
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Secondary survery
C-spine exam: remove collar, examine face and scalp for trauma, inspect for rotational deformiities when holding pts head
Palpate posterior C-spine: tenderness along midline (nuchal ridge to prominence of first thoracic vertebrae) or paraspinal tissues
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Assessment
NEXUS: C-spine can be cleared without radiological evidence if the patient does not have any of the following 5
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Canadian C-spine
High risk patients needing radiological assessment: Age > 65, extremity parasthesia or dangerous mechanism
Patients without the above factors: consider presence of low risk factors and range of motion in neck
Radiology
X-ray
Views: AP, lateral, open mouth odontoid view
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Assess by looking at the four lines on the lateral radiograph, obvious deformities and subtle signs such as soft-tissue swelling, hypolordosis, disk space/interspinous narrowing/widening
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Injuries can include: fractures, spinal cord damage, ligamentous injury, etc. This can lead to irreversible neurological damage.