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Selection of Trauma Victims for Cervical Spine Radiological Examination

Published online by Cambridge University Press:  28 June 2012

Betty L. Bryson ,
Joseph P. Ornato ,
Robert R. Farquharson ,
Patrick J. Donovan  and
Francis G. Palaio
Betty L. Bryson
Affiliation:
From the Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Joseph P. Ornato
Affiliation:
From the Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Robert R. Farquharson
Affiliation:
From the Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Patrick J. Donovan
Affiliation:
From the Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Francis G. Palaio
Affiliation:
From the Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
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Extract

Evaluation of the traumatized patient frequently involves consideration of possible cervical spine injury. When neurological deficits, unconsciousness, alcoholic intoxication, severe maxillofacial or head trauma, or local neck pain are present, it is an easy decision to obtain cervical spine x-rays. The dilemma arises in the patient without neck pain who has mild to moderate scalp or facial injuries. Such a patient usually arrives in the emergency department with a cervical collar placed by pre-hospital personnel because of the mechanism of injury and the associated head or facial soft tissue trauma. Due to the association of cervical spine fractures with “significant” facial trauma, neck x-rays have been recommended. What, however, constitutes “significant” facial trauma To delineate such facial injuries, a retrospective analysis of 30 patients with cervicalspine fractures hospitalizedin a five year period at the University of Nebraska Medical Center was performed. Seventeen patients had head, scalp or facial injuries ranging from skull fractures and scalp hematomas to minor abrasions and lacerations. To determine if cervical spine films are being over utilized, a current prospective study of patients undergoing this evaluation will be presented, detailing the facial and head injuries, location, degree of severity, and detection of cervical spine injuries.

Type
Part II: Clinical Care Topics
Information
Prehospital and Disaster Medicine , Volume 1 , supplement S1: Disaster Resuscitology , 1985 , pp. 199 - 202
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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