Login
Site Search
Trauma-List Subscription

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription

Modify

Home > List Archives

C-spine clearance

meredith mcbride trauma-list@trauma.org
Thu, 24 Apr 2003 11:42:37 -0700 (PDT)


--0-571300677-1051209757=:48176
Content-Type: text/plain; charset=us-ascii

Hey super - thanks, Karim. I've quoted below, this from the section on clearing c-spine in the unconcious patient:
There are several studies that have demonstrated the robustness of the full CT scan...Widening, slippage or rotational abnormalities of the cervical vertebrae suggest soft tissue injury. An absence of such signs appears to exclude significant instability... No study has missed a cervical spine injury, and no study has identified an injury on plain films that was not apparent on the CT scan. 
This pretty plainly states that CT is diagnostic for soft tissue injury. So this brings me back to my original question with regards to a previous comment by ERF: "If a patient is tender, or is unevaluable, the 3 views (or what is becoming increasingly clear, CT) is only the first step--the collar cannot be removed unless the patient is then documented to have no pain on passive AND active exam, or, if persisitently unevaluable or tender, an MRI or uprite flex-ex is normal."
Is there new data in the pipeline that CT is not adequate for diagnosis? Wondering if our practice of using CT is showing some weaknesses... Meredith

Karim Brohi <karim@trauma.org> wrote:Try this... http://www.trauma.org/spine/cspine-eval.html Karim


---------------------------------
Do you Yahoo!?
The New Yahoo! Search - Faster. Easier. Bingo.
--0-571300677-1051209757=:48176
Content-Type: text/html; charset=us-ascii

<DIV>Hey super - thanks, Karim. I've quoted below, this from the section on clearing c-spine in the unconcious patient:</DIV>
<DIV>
<P><EM>There are several studies that have demonstrated the robustness of the full CT scan...Widening, slippage or rotational abnormalities of the cervical vertebrae suggest soft tissue injury. An absence of such signs appears to exclude significant instability... No study has missed a cervical spine injury, and no study has identified an injury on plain films that was not apparent on the CT scan. </EM></P></DIV>
<DIV>This pretty plainly states that CT is diagnostic for soft tissue injury. So this brings me back to my original question with regards to a previous comment by ERF: "If a patient is tender, or is unevaluable, the 3 views (<STRONG>or what is becoming increasingly clear, CT</STRONG>) is only the first step--the collar cannot be removed unless the patient is then documented to have no pain on passive AND active exam, or, if persisitently unevaluable or tender, an MRI or uprite flex-ex is normal."</DIV>
<DIV><BR>Is there new data in the pipeline that CT is not adequate for diagnosis? Wondering if our practice of using CT is showing some weaknesses...</DIV>
<DIV>&nbsp;</DIV>
<DIV>Meredith<BR><BR><B><I>Karim Brohi &lt;karim@trauma.org&gt;</I></B> wrote:</DIV>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">
<META content="MSHTML 6.00.2600.0" name=GENERATOR>
<DIV><SPAN class=360384817-24042003><FONT color=#0000ff size=2>Try this...</FONT></SPAN></DIV>
<DIV><SPAN class=360384817-24042003><FONT color=#0000ff size=2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=360384817-24042003><FONT color=#0000ff size=2><A href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://www.trauma.org/spine/cspine-eval.html">http://www.trauma.org/spine/cspine-eval.html</A></FONT></SPAN></DIV>
<DIV><SPAN class=360384817-24042003><FONT color=#0000ff size=2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=360384817-24042003><FONT color=#0000ff size=2>Karim</FONT></SPAN></DIV></BLOCKQUOTE><p><br><hr size=1>Do you Yahoo!?<br>
<a href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2003-April/"http://us.rd.yahoo.com/search/mailsig/*http://search.yahoo.com">The New Yahoo! Search</a> - Faster. Easier. Bingo.
--0-571300677-1051209757=:48176--