"I saw a man on the ground with a police officer holding his c-spine to stabilize him," Bosco tells PEOPLE.
|
|
The Canadian C-spine rule for those with a normal Glasgow coma scale and who are otherwise stable Paramedics are able to accurately determine who needs or does not need neck immobilization based on an algorithm. There are two main algorithms, the Canadian C-spine rule and NEXUS. The Canadian C-spine rule appears to be better. However, following either rule is reasonable.
|
|
On 24 February 2007 O'Connor suffered a fractured c-spine at C6 - C7 with spinal cord damage following an accident whilst training for the upcoming season. Although disabled, O'Connor is able to walk short distances unaided.
|
|
If the patient is not expected to be clinically evaluable within 48–72 hours because of severe head or multiple injuries, they should remain immobilized until a time when such an examination is possible. A 64-slice CT with reconstructions does not entirely rule out ligamentous injury leading to instability, but is a practical means of identifying the majority of C-spine injuries in obtunded patients. MR C-spine suffers from frequent false-positives, limiting its usefulness. In these cases, a consultation with a Spine Surgery specialist is prudent.
|
|
A medical history and physical examination can be sufficient in clearing the cervical spine. Notable clinical prediction rules to determine which patients need medical imaging are Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS).
|
|
Some trainers and protocols use an additional (small) 'c' in between the A and B, standing for 'cervical spine' or 'consider C-spine'. This is a reminder to be aware of potential neck injuries to a patient, as opening the airway may cause further damage unless a special technique is used.
|
|
There are three general types of RMA, designated by scope. In the widest sense, the patient may even refuse to be evaluated by EMS. Generally, however, the patient will submit to an evaluation (consisting of vitals and an assessment) before asking or being asked about refusal by the EMS agency. Or a patient may refuse only specific actions, such as C-spine precautions.
|
|
A medical history and physical examination can be sufficient in clearing the cervical spine. Notable clinical prediction rules to determine which patients need medical imaging are Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS). The AO Foundation has developed a descriptive system for cervical fractures, the AOSpine subaxial cervical spine fracture classification system. The indication to surgically stabilize a cervical fracture can be estimated from the Subaxial Injury Classification (SLIC).
|
|
The clivus is an important landmark for checking for anatomical atlanto-occipital alignment; the clivus, when viewed on a lateral C-spine X-ray, forms a line which, if extended, is known as Wackenheim's clivus line. Wackenheim's clivus line should pass through the dens of the axis or be tangential to it.McKenna DA, Roche CJ, Lee KW, Torreggiani WC, Duddalwar VA. Atlanto-occipital dislocation: case report and discussion. Can J Emerg Med 2006; 8(1):50-3.
|
|
In radiology, the thumbprint sign, or thumbprinting, is a radiologic sign found on a radiograph that suggests the diagnosis of either epiglottitis or intestinal ischemia. In a lateral C-spine radiograph, the sign is caused by a thickened free edge of the epiglottis, which causes it to appear more radiopaque than normal, resembling the distal thumb. In an abdominal radiography, thumbprinting has an appearance of thumbs protruding into the intestinal lumen, and is caused by thickened edematous mucosal folds.Page 111 in: Abdominal thumbprinting is a non-specific finding, though one potential cause is intestinal ischemia.
|
|