[Clinical analysis of cervical-spine and spinal-cord-injured patients brought in without cervical spinal immobilization].
The purpose of this study was to determine the incidence of mismanaged injury of the cervical spinal cord, to identify factors contributing to a failure to recognize such injury. Thirty-three patients with cervical spinal cord injury were transported to emergency department during the period from October, 1999 to March, 2001. Seven patients (21%) of them were transferred without cervical spine immobilization. Mechanism of injury in 7 patients was fall in 4, motor vehicle crash in 2, unknown in one. Clinical signs on admission revealed neck pain and/or back pain in 4 patients, altered mental status in 4 patients, numbness of extremities in 2 patients, paradoxical respiration in 2 patients, respiratory arrest in one. Neurological classification of Frankel grade was A in 2, B in 1, C in 2, D in 1 and E in 1. All trauma patients with a cervical spine injury or with a mechanism of injury having the potential to cause cervical spine injury should be immobilized at the scene, during transport and at the emergency room by using one of several available methods.
Division of Emergency Medicine, Teine Keijinkai Hospital, Sapporo, Japan. t-isao@keijinkai.or.jp
Isao
I
Takahashi
Yuka
Y
Morishita
Satoshi
S
Nanzaki
Tatsuya
T
Hayakawa
Shunsuke
S
Terasaka
Mitsuru
M
Nunomura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000628:therapy*; D013124:Spinal Injuries / Q000175:diagnosis / Q000628:therapy*; D014187:Transportation of Patients