PREVIEW OF

EMT/EMR NERVOUS SYSTEM TRAUMA

POWERPOINT TRAINING PRESENTATION

SPINE

Spinous processSpinal Fluid

SPINAL SYSTEM

Consists of the brain, spinal cord, and the vertebra

RACCOON EYES BATTLE’S SIGNS

Bruising behind the ear

ears over mastoid process

Both normally does not show up for hours after injury

CONCUSSION

AKA Minor head traumaThe most common traumatic brain injuryCaused by the jarring of the brain, resulting in

temporary signs & symptoms Repeated concussions may lead to permanent

brain damageCommonly seen in contact sports, car accidents,

falls & bicycle accidents

CEREBRAL LACERATION

Traumatic brain injury where the brain is torn Similar to a Contusion but more severe due to greater force Signs & symptoms

Lucid interval with no change in level of consciousness

Level of consciousness will decrease as laceration bleeds & blood builds up into skull

PENETRATING WOUNDS

Common causes include gun shot, arrows, metal rods, & other high velocity projectiles

Often have exit woundHas high mortality rate (up to 92%)Signs & symptoms vary depending upon parts of

brain affected

SPINAL IMMOBILIZATION

In patients with head injuries with altered mental statusMechanism of injury that suggests the possibility

of trauma to the spine

COMPLETE NEUROLOGICAL EXAM

Vital signsBlood pressure

Systolic pressure increaseHypotension is associated with

poorer outcomes in head injured patients

Pulse rate – may be slower than normal if severe head injury

TRAUMATIC BRAIN INJURY FOUNDATION GUIDELINES

They have treatment guidelines for EMS for concussions as well as other traumatic brain

injurieswww.braintrauma.org

SPINAL CORD INJURIESCan cause paralysis below injury which can lead

to death C1C6

Neck Functions L1L4

Thigh Flexion

C1T1

Neck Extensors L2L4

Thigh Adduction

C3C5

Supply Diaphragm

L4S1

Thigh Abduction

C5C6

Shoulder Arm

L5S2

Leg Extension at hip

C6C7

ElbowWrist

L2L4

Extension of leg at knee

C7T1

Wrist flex L4S2

Flexion of leg at knee

T1T6

Intercostal & Trunk

L4S1

Flexion of foot

T7L1

Abdominal Muscles L4S1

Extension of toes

OPEN SPINE WOUND

Often caused by projectilesHas high susceptibility for paralysis & infection

NEUROLOGICAL EXAMINATION CONSIDERATIONS

Movement of extremitiesAbsent or weakNote level of impairment

Respiratory abilityChest wall movementAbdominal Excursion

SensationPresent throughout bodyAbsent – note the specific level of impairment

Altered sensation distal to injury – jingling, numbness,“electric shocks”

GENERAL MANAGEMENT CONSIDERATIONS WITH SPINAL TRUAMA

Manual immobilization of spine when airway openedImmobilization principlesLog-roll patient with suspected spinal trauma to move or examine backCervical collars

RigidProper size

VARIATIONS FOR GERIATRIC ASSESSMENT AND MANAGEMENT OF SPINAL INJURY

Unusual spinal anatomy due to agingSpecial modifications of spinal immobilization

techniques

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