C-Spine Trauma
Summary: <br> Step 1: Protect the Spine<br> <br> <br> <br> * Apply cervical collar<br> <br> <br> <br> Step 2: Apply NEXUS Criteria<br> <br> <br> <br> * Use the “SPINE” mnemonic* Spinal midline tenderness* Painful distracting injury* Intoxication* Neurologic deficit* Encephalopathy<br> <br> <br> <br> Step 3: If Patient Has None of the NEXUS Criteria… You Are Done!<br> <br> <br> <br> Step 4: If Patient Has Positive NEXUS Criteria…<br> <br> <br> <br> * Obtain CT scan of the cervical scan without contrast<br> <br> <br> <br> Step 5: Clear the C-Spine<br> <br> <br> <br> * If CT scan negative -> Have patient turn head 45 degrees to right and left* If patient has no limitation and no paresthesias or neurologic deficit…* Remove collar* If still concerned for spinal injury despite normal CT* Keep collar on and have patient follow up in clinic for reexam<br> <br> <br> <br> Unstable Cervical Spine Fractures<br> <br> <br> <br> * Mnemonic: Jefferson Bit Off a Hangmans Tit* Jefferson fracture* Bilateral facet dislocation* Odontoid fracture* Atlantooccipital dislocation* Hangman’s fracture* Teardrop fracture<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * NEXUS Criterial for C-Spine Imaging <a href="https://www.mdcalc.com/nexus-criteria-c-spine-imaging">(MDCalc)</a>* Unstable Spine Fractures <a href="https://wikem.org/wiki/Unstable_spine_fractures">(WikEM)</a><br>
