Q) Out of the following, which patient requires spinal immobilization the most?
✅ Answer: A. 22-year-old female involved in a high-speed motor vehicle collision with back pain
🔍 Explanation:
Spinal immobilization is most indicated when there's a high-risk mechanism of injury with suggestive symptoms, such as midline spinal pain or neurological signs.
A involves a high-energy mechanism (MVC) and reported back pain, which is a clear indication for spinal immobilization per NEXUS and Canadian C-spine rules.
B has a lower-risk mechanism and no symptoms; thus, spinal immobilization is generally not needed.
C – Gunshot wounds may or may not need spinal immobilization depending on location and neurological findings; not always indicated unless spinal structures are involved.
D – Isolated abdominal trauma is not an indication for spinal immobilization unless there’s evidence of spinal involvement.
⚡ Mechanism of Injury:
• Blunt trauma – Direct impingement, ischemia, compression or bleeding
• Penetrating trauma – Laceration of spinal cord
🩻 Chance fracture: A transverse fracture of all vertebral elements.
🩺 Management:
1. Complete immobilisation
2. Management of associated neurogenic shock (due to loss of sympathetic tone) with vasopressors and fluids
📘 Recommended Reading: Get Surgery Essentials
🔍 Explanation:
Spinal immobilization is most indicated when there's a high-risk mechanism of injury with suggestive symptoms, such as midline spinal pain or neurological signs.
A involves a high-energy mechanism (MVC) and reported back pain, which is a clear indication for spinal immobilization per NEXUS and Canadian C-spine rules.
B has a lower-risk mechanism and no symptoms; thus, spinal immobilization is generally not needed.
C – Gunshot wounds may or may not need spinal immobilization depending on location and neurological findings; not always indicated unless spinal structures are involved.
D – Isolated abdominal trauma is not an indication for spinal immobilization unless there’s evidence of spinal involvement.
⚡ Mechanism of Injury:
• Blunt trauma – Direct impingement, ischemia, compression or bleeding
• Penetrating trauma – Laceration of spinal cord
🩻 Chance fracture: A transverse fracture of all vertebral elements.
🩺 Management:
1. Complete immobilisation
2. Management of associated neurogenic shock (due to loss of sympathetic tone) with vasopressors and fluids
📘 Recommended Reading: Get Surgery Essentials