Clearing the cervical spine

Background

• Victims of blunt trauma who are fully alert and show no signs of intoxication can safely forego cervical spine radiography if they have no midline neck tenderness, no neurological deficit and no distracting injury [BestBets]
• These rules are applicable to patients over the age of nine. [Bestbets]
• Peg views are not required in children under 5 years of age
• All patients being admitted to ITU (Δ level of consciousness or distracting injury) will have spinal precautions maintained until cleared by the relevant in-patient team
• All patients with blunt trunk trauma whose neck has not been cleared should have imaging of dorsal and lumbosacral spine. Maintain spinal precautions until imaging completed at a later time - not necessarily before transfer to ITU - unless early high suspicion of spinal injury

Approach

Links

• Vascular injuries in neck trauma (NB in fractures near foramen transversarium)