Improving medical students

Cervical Spine Injuries in the ER

Posted by medliorator on February 14, 2009

Not everyone with a neck injury calls 911… and some of them walk in themselves. Such was the case of a high school football player whose coaches thought had suffered a “stinger” during a game. After a tackle, he developed neck pain and numbness to the left arm.

When someone walks into the ER on their own power, our clinical suspicion for serious injury is sometimes reduced. I can only assume this is why he wasn’t immobilized in triage. When I entered the room, I found him sitting upright in a wheelchair in mild distress from pain… He appeared to be holding his head very still so as not to move his neck at all. He was exquisitely tender to the lower midline of his posterior neck. He was slightly weak in his left upper arm but had normal grip strength.

I skipped the X-rays and sent him straight to the CT scanner, where he was found to have a burst fracture of C4 and some injuries to the posterior elements of C5.

The Stinger [Scalpel or Sword?]

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