>Anyone fancy doing a "best BETS" on the clinical question:
>A 17 year old woman falls off her horse / had a low-impact RTA, is not knocked
>out,
>has no neuro features, no distracting injuries, no midline neck tenderness but
>has a
>10% reduction of neck movements due to slight discomfort at extremes of
>movement.
>You order a C-spine Xray according to guidelines. You wonder what the chance is
>of a
>significant positive finding on the XRay?
>
>Dr G Ray
>Staff Grade
>A&E
>Sussex
>Reply to [log in to unmask]
A low speed RTA is not the same as a fall from a horse. In my view, all
falls from these dangerous beasts involve significant injury.
Like must be compared with like. In these two cases, the forces involved
are quite different. (see Mr Fogarty's posting)
The horsewoman should be xrayed and her hideous fracture/dislocation
demonstrated. The car driver is probably only there for documentation
for litigation purposes. The purpose of irradiating this latter group is
to stop them breeding.
There are, of course exceptions. If I do not find an injury after a
horse-related accident, I sleep poorly.
I shall feed this into my BET machine and see what comes up with regard
to the driver. I won't do it for the equestrian because no good ever
came from BETting on horses.
--
Stephen Hughes
SpR Harlow
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