Clearing the C-spine

Michaela Cartner, MBBS, FACEM, FCICM, PG Dip Echo

Intensivist GCUH

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.

Neuro deficit

Soreness in the midline

Alert

Intoxication

Distracting injuries

History

Age

ACTIVE movement

?

NEJM 2003;349:2510-8

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

PAN SCAN MAN GRAM

Am J Emerg Med 1991 Sep 9(5) 421-5, Journal of Trauma 1996 April 30 (4) 392-7

85%

15%

EMST

A B C D E

A is for Alignment and Adequacy

1.Anterior vertebral line

2. Anterior spinal line

3. Posterior spinal line

4. Vanishing point

B is for Bone/box and tick

C is for Cartilage

Disks

Facets

D is for Dens

Predental space is 3mm

Lateral borders should match

Symmetry is your friend

E is for extra axial

7-3-3-77mm at C3

3cm at C7

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….

Coronal views

Controversies

Protocols which one and where?

The hard collar

Does clearing the spine include the CTA?

Protocols

There is an app for that

In the bright era of choosing

wisely….

Local protocols + the Hard Collar

C-Spine and the CTA

CTA and clearing the spine

THANK YOU