Clinical Pathways
Clinical Pathways
Not stable
Not stable

Not stable

View The Full Pathway

Action

  • Initiate cervical immobilization (Class I)
  • Image the cervical spine with noncontrast CT; use 3- or 5-view plain film if CT unavailable (Class I)
  • Resuscitate with MAP goal of 85-90 mm Hg (Indeterminate)
  • Maintain inline cervical stabilization during intubation (Class III)

Decision

Is a spinal injury identified?

Yes

  • Do NOT administer methyl-prednisolone unless recommended by consultant (Class I)
  • Transfer to acute specialized SCI center (Class III)
  • Obtain neurosurgical or orthopedic spine consultation
  • Consider MRI to aid in defining injury (Class III)
  • Consider CTA in cases of:
    • Cervical spine fracture, especially C1-C3 or involving transverse foramen (Class II) or
    • If high risk by Denver criteria (see Table 9) (Class II)
  • Complete remainder of trauma evaluation. Admit or transfer to ICU (Class II) or spinal injury center (Indeterminate)

Background

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References
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    91. ®

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Full Cervical Spine Injuries Pathway
Full Cervical Spine Injuries Pathway

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