ABSTRACT
Evaluation and management of cervical spine (C-spine) injuries constitute mandatory knowledge for the traumatologist because up to 3% of trauma victims will have C-spine fractures, with ligamentous injuries occurring in an even greaternumber (1).Manyof thesepatientswill require immediate airway intervention. However, cervical manipulations during airway management can potentially exacerbate a spinal cord injury (SCI).Nearly all formsof airway intervention will cause somemovementof theC-spine.There are at least two reported cases of quadriplegia occurring after airway intervention in previously neurologically normal patients. In addition, maintenance of C-spine protective equipment and protocols complicate airwaymanagement (rigid collar, inline immobilization, etc.) and should not bemaintained longer than necessary in patients who do not have significant injury. The overall incidence of unstable C-spine injury in blunt trauma
This chapter provides a contemporary approach to initial evaluation and management of trauma patients with known or suspected C-spine injuries. It is recognized that imaging decision-making varies depending upon the condition of, and risk to, the patient. To this end, three major patient categories are assigned different imaging rules: (i) low risk alert; (ii) high risk alert; and (iii) obtunded.
