Trauma - Case 2

Trauma Case 2

Module Author: Kevin Baumlin, MD
Web Author: Michael Bessette, MD

Situation

A 29 y.o. female, Dominique Violencia, is BIBEMS with a complaint of head and neck pain. She states that she was in an argument with her boyfriend when he hit her on the top of the head with a large object. She is awake and alert and crying because she states that she cannot move her legs. She is in a collar and on a board. Her vitals are 130/76 hr 74 rr 17.

1. How do you "clear" a C-spine?

2. Review how to read a normal C-spine series.

3. Given the clinical findings below, give the appropriate spinal cord syndrome and pathophysiology.

A. Bilateral loss of motion in all extremities and loss of sensation below the neck, intact peri-anal sensation.

B. Patient with a stab wound to the back and loss of motion of the right lower extremity and loss of sensation on the left side below the nipple and no incontinence.

C. Patient in a MVA with weakness of both upper extremities, normal motor function in the lower extremities and normal sensation.

Your patient has her Cspine cleared clinically, then she wants to go home because she "just has to". You ask the social worker to speak with the patient about domestic violoence.

		1.	How do you "clear" a C-spine?

		2.	Review how to read a normal C-spine series.

		3.	Given the clinical findings below, give the appropriate spinal cord syndrome and pathophysiology.
			A. Bilateral loss of motion in all extremities and loss of sensation below the neck, intact peri-anal sensation.

			B. Patient with a stab wound to the back and loss of motion of the right lower extremity and loss of sensation on the left side below the nipple and no incontinence.

			C. Patient in a MVA with weakness of both upper extremities, normal motor function in the lower extremities and normal sensation.

		Your patient has her Cspine cleared clinically, then she wants to go home because she "just has to". You ask the social worker to speak with the patient about domestic violoence.