>>> [log in to unmask] 12/18/00 11:53 >>>
Cervical collars should be routinely applied to patients involved in any
MVA, fall, hanging or other injuries that have resulted from a force acting
on the body that may compromise the stability of the C-spine. A spinal
injury can only be confirmed or ruled out by X-ray.
Have to disaggree with this one, the MOI is irrelevant and an x-ray is not required to rule out injury if you can clinically clear the neck, the details of which have been thrashed to death on this list before and Im sure are archived. The clinical clearence of the c-spine is entirely appropriate in the pre-hospital environment and the safety of clinical clearence has been confirmed by NEXUS I. The over zealous use of immobilisation of patients who dont need it causes them significant distress - Im not critising pre-hospital guys alone, alot of the ED staff can be just as guilty. I think like a lot of things its simply an experience issue - but we must avoid blanket, absolute statements like the above
Craig
P.S - given the almost complete absence of spinal injuries in deliberate (non-judicial hanging) hangings - why do we still consider hanging yourself from your tie on the back of a door an at risk injury for c-spine injuries ??
Dr Craig Ellis
Emergency Medicine Registrar (suffering in slience in general paed's)
Wellington Hospital
Wellington, New Zealand.
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