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Spinal Trauma

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This program review Spinal Trauma management.

This program review Spinal Trauma management.

Published in: Health & Medicine

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  • Transcript

    • 1. Spinal Trauma
    • 2. Learning Objectives
      • At the end of the presentation the student will be able to
        • Describe the assessment finding associated with head and spinal injuries.
        • Identify the need for rapid transportation of the patient withheld and spinal injuries.
        • Describe the assessment finding associated with traumatic spinal injuries.
        • Differentiate between spinal injuries based upon the assessment and the history.
        • Formulate a field impression based upon the assessment of spinals injuries.
        • Develop a patient management plan based upon the field impression.
        • Describe the management of the traumatic spinal injury patient.
    • 3. Introduction
      • 1.25 Million to care for a single victim
        • Overall life span
      • 15,000 - 20,000 SCI /year
      • Higher in Men 16 - 30 yrs old
      • Causes
        • MVA 2.1 million per yr (48%)
        • Falls (21%)
        • Penetrating Injuries (15%)
        • Sports injuries (14%)
    • 4. Morbidity and mortality
      • 40% of trauma patient with neuro deficit will have temporary or permanent SCI
      • 25% of SCI may be caused by improper handling
    • 5. Anatomy review
      • Cervical - 7
      • Thoracic - 12
      • Lumbar - 5
      • Sacral - 5
      • Coccyx - 4 (1)
    • 6. Vertebral Body
      • Transverse process
      • Spinous process
      • Intervertebral foramen
      • Intervertebral Disk
    • 7. Spinal Nerves
    • 8. Assessment
      • Positive MOI
        • High speed MVA
        • Falls > three x height
        • Stabbing
        • GSW
        • Sports injuries
        • ????
    • 9. Critical Criteria
      • Initial management based upon MIO
      • Positive MIO - immobilize
      • Uncertain MIO - further assessment
    • 10. Milwaukee County Protocol
    • 11. Asses for spinal pain
      • Any related spinal pain
        • Any pain with movement
      • Signs
      • Symptoms
      • Palpate over each spinous process
      • Sensory function
      • Motor function
    • 12. Management for Spinal Injuries
      • Prevent further injury
      • Treat as long bone with joint at either end
      • 15% of secondary injuries are preventable
      • ALWAYS complete spine immobilization
      • Reassess after immobilization
    • 13. Immobilization
      • Cervical immobilization
      • KED
      • Long board
      • Padding
      • Straps
      • Cervical immobilization Device
    • 14. Helmeted Patients
      • Indications for leaving a hemet in place.
      • Indications for helmet removal
    • 15. Case
      • You are dispatched to a single vehicle MVA.
      • Upon arrival you find a unconscious not breathing patient laying across the front seat of the vehicle.
      • What are your priorities?
      • How do you achieve them?
    • 16.
      • The patient is rapidly extricated and placed on a long board with in-line stabilization.
      • The space between the board and the head was approximately 6”
      • What would you do?
    • 17.
      • He is placed in the ambulance and ventilation is attempted without success.
      • What would you do now??
    • 18.
      • Using a laryngoscope you observe a “Breath saver” lodged on the vocal cords.
      • It is removed.
      • Would to intubate this patient??
    • 19.
      • The patient is intubated and two large bore IV are placed.
      • Vital signs
        • Resp - ventilated
        • Pulse - 110
        • BP - 140/76
        • AVPU - unresponsive
        • Pupils - sluggish
      • Patient is transported without delay.
    • 20.
      • Upon arrival to the Level I Trauma Center the patients condition is unchanged.
      • X-ray
      • Labs
      • ET placement is confirmed with X-ray
    • 21.  
    • 22.
      • The patient is admitted to TLC
      • His cervical spine is repaired
      • His thoracic spine is repaired
      • His lumbar spine is repaired
      • His closed head injury/skull fx is treated with observation
      • He recovers full in approximately 6 weeks
      • No neurological deficits
    • 23.  
    • 24.