03-26-2009, 06:41 PM
CC
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most miss this Q - boy123
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03-26-2009, 07:08 PM
"Loss of conciousness after trauma": must be CT head first! coz i wanna r/o SDH and Epidural/IC h'ge.
D & E : doesn't make sense X-ray spine an dleg can be done later.
03-26-2009, 07:18 PM
hey, everybody has answered C??? can anyone explain please???
03-26-2009, 07:19 PM
But after resuscitation if you have spine injury you need to immobiloize and you should address it first... then you can see for SDH or epiduaral hemorrage
Correct me If I am wrong...
03-26-2009, 09:51 PM
The ans is C
Explanation: Approximately 5-10% of unconscious patients who present to the ED as the result of a motor vehicle accident or fall. have a major injury to the cervical spine. One third of injuries occur at the level of C2, and one half of the rest occur at the level of C6 or C 7. Most fatal cervical spine injuries occur in upper cervical levels, either at craniocervical junction C1 or C2. This patient had head trauma as evidenced by nature of her injury and epistaxis. Patient with head trauma can have coexisting cervical spine injury, which should always be assessed before mobilizing the patient. Clinical evaluation of the cervical spine in a patient with blurt trauma is unreliable. Because of grave consequences of missing a cervical spine injury, it is important to rule out a fracture or dislocation of cervical spine as the first priority. In the Emergency room this can be done best with a lateral view x-ray of spine. It is 85-90% sensitive in diagnosing cervical spine injury (Choice C) At the site of accident, when cervical spine injury is suspected, the patient should be transported with the neck stabilized with a collar. Tenderness on palpation of cer/ical spine is indicative of a spine injury. (Choice A) This patient has epistaxis suggestive of fracture of base of skull. However, a CT scan is indicated only after cervical spine injury is ruled out and patient is stable. An alternative could be to do a CT scan of head including the neck. (Choice B) Though the patient has an obvious fracture of her left tibia, cervical spine injury is potentially more dangerous and should be ruled out before looking for trauma to other body parts. (Choice D) Lumber puncture has no significant role in assessment of head trauma and is rather contraindicated in head injury unless a CT scan rules out intracranial hypertension. (Choice E) X-ray of head gives very little useful information and CT scan of head is a better alternative to assess head injury- Educational Objective: It is important to rule out a fracture or dislocation of cervical spine as the first priority because of grave consequences of missing a cervical spine injury
03-27-2009, 05:07 AM
i would go with C , x ray-spine
since pupils are reactive that rules out any head injury (i think so..) what is the answer btw |
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