C-spine 3

Scenario:

You are working with an MRT group and get called out to a mountain-biking accident in Northumberland National Park. The information you are given: male casualty, 27yr old, crashed at speed descending on a trail. 

D- you need to check that the route is closed above the accident to prevent a pile-up.

R- patient is responding.

C- no evidence of catastrophic haemorrhage, consider C-spine manual in-line stabilisation due to mechanism.

A- airway is patent, trachea central. 

B- RR is 28, absent breath sounds on one side on auscultation (tension pneumothorax which needs decompression). O2 sats are 89%. After needle decompression and oxygen sats will rise and RR will reduce.

C – HR is 115 bpm, BP is 118/76mmHg. PCR is > 2sec due to cold, CCR is < 2 sec. Chest – not clear, abdo - clear, pelvis – clear, long bones – clear.

D – pupils equal and reactive to light, Alert, temperature is 36.1D, patient complains of tingling in limbs.

E – if asked specifically patient complains of midline tenderness of C-spine.

Priorities: patient needs MILS either straight away or as soon as patient complains of tingling or pain. Needle decompression should be in the 5th intercostal space, anterior axillary line or in the 2nd intercostal space, mid-clavicular line.