What would you have done with this patient I encountered recently - in view
of current guidelines already discussed?
Stationary car hit from behind at less than 20mph. Driver has preexisting
back condition, exacerbation of symptoms (leg pain/paraesthesia worsened
post RTA), no other injuries, walked unaided from vehicle, conveyed to A&E.
Passenger has no previous history, no injuries at time of impact, walking
around on our arrival. Ten minutes later develops neck pain "like a stiff
neck". No neurological symptoms, on examination has bony midline tenderness
approx C7/T1, no obvious paravertebral spasm. I thought best option would be
to fully immobilise - patient adamantly refused despite full explanation of
potential risks. Fully documented decision, patient advised attend A&E etc
but as far as I know had no intention.
Thanks,
Peter Johnson.
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