Traumatic soft tissue injuries to the lower

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back, or abdomen may signal injury of the thoracic or lumbar spine. Traumatic soft-tissue injuries to the lower extremities may signal injury of the lumbar or sacral spine. Severe spinal shock: Failure of the nervous system o(neurogenic shock) can be caused by the failure of the nervous system to control the diameter of blood vessels. The pulse rate may be normal because a message to “speed up” the heart may be prevented from getting to the heart due to the cord injury.
Alexandra HamiltonSmartReviewQuestions: What happened? Where does it hurt? Does your neck or back hurt? Can you move your hands and feet? Can you feel me touching (fingers and toes)? Do you feel “pins and needles”? Strategies—responsive patient Mechanism of Injury Bystander information DCAP-BTLS PMS Palpation Assessment:InspectDCAP-BTLSPalpate for tenderness. oAbdomen oChest wall Assess extremities. oPulses oMotor oSensation Bystander information oWhat happened? oWhat did you see? Patient Care-Spinal injuryManual in-line stabilization Assess ABCs. Rapid trauma exam Assess sensory and motor function. Apply spinal immobilization device. Oxygen Reassess motor and function. Cervical Spine Injuries in Perspective2.4% blunt trauma patients experience some degree of musculoskeletal injury to spine approx. 20,000 spinal cord injuries a year in US $1.25 million to care for a single patient with permanent SPI 15,000-20,000 SCI per year higher in men between ages of 16 – 30
Alexandra HamiltonSmartReviewcommon causes: motor vehicle crashes, falls, etc. Positive MOI- forces of impact suggest a potential spinal injury His speed MVC Falls greater than 3x body height Axial loading Violent situations near the spine : gun shots, stabbing Sports injuries oInfants – 4 y.o. bones have not calcified efficiently. oElders with osteoporosis Other high impact situations Consideration to special person’s population oPediatrics, geriatrics, history of Down’s, spinal bifata, etc. Normal Procedure-ImmobilizationHead and neck manually stabilized C collar applied after assessment Secure to short spine board or extrication vest. oExtrication vest: Flexible piece of equipment useful for immobilizing patients with possible injury to the cervical spine. It can be used when the patient is found in a bucket seat, in a short compact car seat, in a seat with a contoured back, or in a confined space. KED Kansas Backboard XP-1 LSP Halfback Vest Technique-Rapid Extrication Bring the patient’s head into a neutral in-line position. This is best achieved from behind or to the side of the patient. Perform an initial assessment and rapid trauma assessment; then, apply a cervical spine immobilization collar.

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