Spinal Cord Trauma
Physical signs of spinal cord trauma include:
· No movement of arms and/or legs
· Abnormal peripheral vasodilatation
· Lax anal sphincter tone
· Contusions/tenderness/deformity/crepitus on clinical examination of the spine
during the log-roll
The only cervical spine view indicated in the emergency room is the lateral view. The cervical spine must remain protected until the patient is stable enough to undergo the 3 film cervical series, performed either in the radiology suite or in DCCM. "Clearance" of the cervical spine is undertaken according to the guidelines in figure 2 (algorithm).
Any patient who has a cervical spine injury or severe blunt trauma requiring admission to DCCM should have screening AP and Lateral x-rays of the entire thoracic and lumbar spine. Patients with clinical signs of thoracic or lumbar spine injury similarly require radiologic evaluation.
Presently at AH steroids are not used in the acute management of cord injuries.
