Escolar Documentos
Profissional Documentos
Cultura Documentos
Injury
Initial Assessment
and Management
Primary Survey
Adult, children, pregnant women
Priorities are the same !
A Airway with C-spine protection
B Breathing with ventilation
C Circulation with hemorrhage
control
D Disability
E Exposure/Environment
Airways + C-spine Protection
Immediate action
Spinal cord damage is incurable. If in doubt,
immobilize the spine
Suspect C-Spine Injury
Spinal protection
C-spine X-ray when
appropriate
Reevaluation
Conscious Patient
Presence of
paraplegia/quadriplegia /pentaplegia
Neurogenic Shock
Hypotension associated with cervical /high
Spinal “Shock”
Neurologic Not hemodynamic
phenomenon
Occurs shortly after cord injury
Flaccidity
Loss of reflexes
Classification of Injury
Incomplete Complete
Any sensation
No motor /
lower extremity
Sacral sparing
Classifications of Injury
Posterior cord
Anterior cord
Brown – Sequard
Complete transection
Classification of Injury
Morphology
Fracture or fracture / dislocation
Spinal cord injury without radiographic
abnormality (SCIWORA)
Spinal Cord Injury without radiographic
evidence of Trauma (SCIWORET)
Penetrating
Classification of Injury
Morphology
Consider unstable if :
Adequacy
Alignment
Bony abnormality
Base of skull
Cartilage , Contours
Disc space
Soft tissue
C – Spine X-rays
Adequacy
Alignment
Bony abnormality
Cartilage, Contours
Disc Space
Soft tissue
Summary of tests
Neurologic deficit
Avoid delay
Properly Immobilized