Case Studies ch 29Head and Spine Injuries – Gymnast Fall Case Study

35 question-and-answer flashcards covering scene safety, MOI, assessment steps, spinal precautions, neurologic checks, airway concerns, communication, and transport considerations for a head and spine injury case.

What is the EMT’s very first priority when notified of a potential head or spinal injury incident?

Ensure scene safety while mentally preparing for spinal precautions.

Before arriving on scene, which two key preparations should an EMT make for a suspected spinal injury patient?

Don appropriate PPE and gather immobilization/airway equipment (rigid C-collar, long backboard, suction, oxygen).

After finding a prone trauma patient who is awake and breathing normally, what immediate step should follow?

Manually stabilize the cervical spine and begin the primary (ABCs) assessment.

Why must manual in-line stabilization be maintained as soon as you contact a trauma patient?

To prevent further damage to the spinal cord until full immobilization is achieved.

For a 6-foot head-first fall from a balance beam, what injuries should you have a high index of suspicion for?

Cervical spine fracture, spinal cord injury, and associated head trauma.

List three critical details about the mechanism of injury (MOI) you should determine after any fall.

Height of the fall, body position on impact, and the type of surface landed on.

Which trauma assessment mnemonic guides a head-to-toe inspection for injuries?

DCAP-BTLS (Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling).

During the neurologic portion of a full-body exam, what three functions are checked in each extremity?

Pulse, motor function, and sensory perception (PMS).

During SAMPLE history, what specific medication information is crucial to gather?

Any prescription, OTC, or recreational drugs that might affect bleeding, nervous system status, or airway control.

Why is asking about any loss of consciousness important in a head-injured athlete?

It helps identify potential concussion, intracranial bleeding, or change in mental status.

After a patient is fully secured to a long backboard, which three items must be reassessed immediately?

Distal pulse, motor function, and sensory function in all extremities.

What is the primary airway concern once a patient is strapped to a long backboard?

If the patient vomits, they may aspirate because they cannot turn their head.

How can an EMT minimize aspiration risk in an immobilized patient who starts vomiting?

Tip or roll the entire backboard to the side and suction the airway promptly.

Why should an EMT clearly explain each procedure to a conscious trauma patient?

To reduce fear, gain cooperation, and maintain patient trust.

Name two possible patient condition changes that might occur during transport after a spinal injury.

Airway compromise from vomiting and worsening neurologic deficit such as increasing weakness or numbness.

Tingling in a patient’s arms and legs indicates impairment of which neurologic function?

Sensory nerve function.

What does weak handgrip strength suggest in the context of spinal trauma?

Decreased motor function possibly caused by cervical spinal cord involvement.

Which oxygen therapy is recommended for a trauma patient with normal breathing but possible hypoxia risk?

High-flow oxygen via non-rebreather mask at 15 L/min.

What lifting/moving technique should be used to rotate a spinal injury patient from prone to supine?

A coordinated four-person log roll while maintaining in-line stabilization.

Ideally, how many rescuers participate in a safe four-person log roll maneuver?

Four providers—one at the head and three along the torso, hips, and legs.

At what points during patient handling must pulse, motor, and sensory functions be reassessed?

After each movement: post-log roll, after placement on the backboard, and after securing straps.

True or False: Information from bystanders is always more reliable than your patient’s own report.

False—bystander information can help but the patient is usually the best source.

What vital documentation must follow the treatment and transport of any spinal injury patient?

A thorough written patient care report detailing assessments, treatments, and changes in status.

Why should spinal precautions be maintained for all trauma patients until ruled out?

Because unseen spinal injuries can cause permanent neurologic damage if the spine is not protected.

Which device is essential for maintaining cervical spine neutrality during transport?

A properly sized rigid cervical collar.

Describe proper placement of a rigid cervical collar on a seated or supine patient.

Collar should fit snugly under the chin and around the neck without causing airway obstruction or excessive neck extension/flexion.

Which mnemonic summarizes the components of a focused history for any patient?

SAMPLE (Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading up).

In the SAMPLE mnemonic, which component identifies when the patient last ate or drank?

L – Last oral intake.

What four vital signs must be monitored continuously en route for a suspected spinal injury patient?

Respirations, pulse, blood pressure, and oxygen saturation (plus mental status).

High-flow oxygen delivered through a non-rebreather mask is typically set to what flow rate?

Approximately 15 liters per minute.

Why must you instruct a conscious spinal-injury patient to remain completely still?

Any voluntary movement could aggravate spinal cord damage.

When should a prone patient with a suspected spinal injury be turned to a supine position?

As soon as airway and breathing are adequate and enough personnel are available for a controlled log roll.

What is the potential consequence of moving a spinal patient without proper stabilization?

Worsening of vertebral displacement and irreversible spinal cord injury.

In trauma assessment, how is the term "index of suspicion" best defined?

The clinician’s anticipation of specific injuries based on the mechanism of injury and clinical findings.

Would the gymnast in this case be classified as a critical patient, and why?

Yes—due to high-energy mechanism, neurologic deficits (tingling, weakness), and risk of rapid deterioration.