A couple of useful articles on Twitter in last 24 hrs. Check em out. Good information on prehospital cervical spine care and issues on airway management
PREHOSPITAL CERVICAL SPINE IMMOBILIZATION AFTER TRAUMA MARCH 2013
SPINAL CORD INJURY AND DIRECT LARYNGOSCOPY – THE LEGEND LIVES ON
Thanks to @socalexmd ( Alex Sammel) and @STHJournalClub for those tweeted articles!
Also Mr EmCrit just posted a new podcast on his Practical Evidence blog on new ATLS guidelines on spinal cord injury.
2 thoughts on “Updates in cervical spine issues in trauma care 2013”
SCI from direct laryngoscopy is no legend. The fact that cases are not published does not mean they don’t happen. I know a tragic case of a 22 year old woman who was intubated by a prehospital emergency doctor without manual in-line stabilisation. She was fully conscious before the intubation without any signs of a SCI. She was the victim of a road traffic accident and the intubation was performed to get her pain from an assumed pelvic fracture under control. Trauma-CT then showed no pelvic fracture but a displaced odontoid fracture with severe damage to the myelon. The woman was tetraplegic and later died from further complications of this injury. I have no doubt that this woman was killed by direct laryngoscopy without manual in-line stabilisation.
you should publish or encourage those involved to publish that case.
I agree with you.
the controversy is whether Manual neck immobilisation does prevent worsening or indeed any SCI in someone with cervical spine fracture and instability.
the BJA editorial I cite still recommends MILS precautions during DL for cervical spine disease or injury.