1365-2044/asset/olbannerleft.gif?v=1&s=bd83df57543a1d11ffc15f630bb1301f0be80859)
1365-2044/asset/olbannerright.gif?v=1&s=682381a959ba60d2021adaffc90d459e71bfcaba)
Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening
Article first published online: 16 APR 2004
DOI: 10.1111/j.1365-2044.2004.03666.x
Additional Information
How to Cite
Morris, C. G. T. and McCoy, É. (2004), Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening. Anaesthesia, 59: 464–482. doi: 10.1111/j.1365-2044.2004.03666.x
Publication History
- Issue published online: 16 APR 2004
- Article first published online: 16 APR 2004
- Accepted: 12 December 2003
- Abstract
- Article
- References
- Cited By
Keywords:
- Spinal injuries;
- Neck injuries;
- Diagnostic imaging;
- Multiple trauma;
- Unconsciousness
Summary
Cervical spine injury occurs in 5–10% of cases of blunt polytrauma. A missed or delayed diagnosis of cervical spine injury may be associated with permanent neurological sequelae. However, there is no consensus about the ideal evaluation and management of the potentially injured cervical spine and, despite the publication of numerous clinical guidelines, this issue remains controversial. In addition, many studies are limited in their application to the obtunded or unconscious trauma victim. This review will provide the clinician managing unconscious trauma victims with an assessment of the actual performance of clinical examination and imaging modalities in detecting cervical spine and isolated ligamentous injury, a review of existing guidelines in light of the available evidence, relative risk estimates and a proposed management scheme.