05-11-2007, 09:32 PM
A 45-year-old man is struck by a motor vehicle and is transported by a med flight to the local emergency department. He is reported to be intoxicated with a Glasgow score of 12/15 on the scene of the accident. He was struck by a vehicle while crossing the street. On arrival, the patient is awake and somewhat combative. He is alert to person only. His temperature is 37.0 C (98.6 F), blood pressure is 150/80 mm Hg, pulse is 112/min, and respirations are 20/min. Primary survey reveals a well-developed man in mild distress. He is in a cervical collar. He has obvious lower extremity tibia fractures bilaterally and a laceration on his forehead. The most appropriate manner to clear the patient's cervical spine from injury is
A. cervical spine plain radiographs
B. CT scan of the neck
C. flexion, extension, and lateral rotation of the neck while assessing any pain response from the patient
D. manual palpation of the patient's neck for any obvious injury
E. this patient cannot have his cervical spine cleared at this time
A. cervical spine plain radiographs
B. CT scan of the neck
C. flexion, extension, and lateral rotation of the neck while assessing any pain response from the patient
D. manual palpation of the patient's neck for any obvious injury
E. this patient cannot have his cervical spine cleared at this time