Download - Clearing the C-Spine by Dr Michaela Cartner
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Clearing the C-spine
Michaela Cartner, MBBS, FACEM, FCICM, PG Dip Echo
Intensivist GCUH
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Today in 10 mins
Historical facts to make you shine in the
fellowship!
EMST and the CT
There’s an app for that….
Controversies and my approach.
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Neuro deficit
Soreness in the midline
Alert
Intoxication
Distracting injuries
History
Age
ACTIVE movement
?
NEJM 2003;349:2510-8
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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PAN SCAN MAN GRAM
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Am J Emerg Med 1991 Sep 9(5) 421-5, Journal of Trauma 1996 April 30 (4) 392-7
85%
15%
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EMST
A B C D E
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A is for Alignment and Adequacy
1.Anterior vertebral line
2. Anterior spinal line
3. Posterior spinal line
4. Vanishing point
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B is for Bone/box and tick
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C is for Cartilage
Disks
Facets
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D is for Dens
Predental space is 3mm
Lateral borders should match
Symmetry is your friend
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E is for extra axial
7-3-3-77mm at C3
3cm at C7
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Am J Emerg Med 1991 Sep 9(5) 421-5, Journal of Trauma 1996 April 30 (4) 392-7
85%
15%
So with a CT….
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Coronal views
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Controversies
Protocols which one and where?
The hard collar
Does clearing the spine include the CTA?
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Protocols
There is an app for that
In the bright era of choosing
wisely….
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Local protocols + the Hard Collar
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C-Spine and the CTA
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CTA and clearing the spine
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THANK YOU