Pediatric emergency medicine trisk 3585 3585
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (99.63 KB, 1 trang )
TABLE 112.6
SIGNS AND SYMPTOMS OF CERVICAL SPINE INJURY
Abnormal motor examination (paresis, paralysis, flaccidity, ataxia, spasticity,
rectal tone)
Abnormal sensory examination (pain, sensation, temperature, paresthesias, anal
wink)
Altered mental status
Neck pain
Torticollis
Limitation of motion
Neck muscle spasm
Abnormal or absent reflexes
Clonus without rigidity
Diaphragmatic breathing without retractions
Spinal (neurogenic) shock (hypotension with bradycardia)
Priapism
Decreased bladder function
Fecal retention
Unexplained ileus
Autonomic hyperreflexia
Blood pressure variability with flushing and sweating
Poikilothermia
Hypothermia or hyperthermia
Management
While attending to the basic ABCs of trauma resuscitation, the clinician should
stabilize the cervical spine. An appropriately sized hard cervical collar should be
chosen. The longest collar that does not hyperextend the neck is the correct
choice. The choice between a one-piece collar (e.g., Stifneck) and a two-piece
collar (e.g., Philadelphia) is important only in that correct fit must be ensured and
the provider must understand how to apply the specific brand of collar. It is
helpful to fold over the Velcro connectors on the collar before sliding them under
the patient’s neck to avoid Velcro attachment to the child’s hair or clothing. If a
patient is seated and needs to have a collar placed, this maneuver should be
accomplished by positioning the collar’s chin portion first, followed by the
placement of the posterior portion. If the patient is wearing a helmet, it should be
