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Management of Cervical Spine Injuries-Scenario 3: Normal Mental Status without Cardiorespiratory Compromise

The most common clinical scenario encountered by the sports medicine physician is the athlete with normal mental status and without cardiorespiratory compromise. Catastrophic cervical spine injury, however, can still occur in this scenario often insidiously.

After the primary survey, a neurologic assessment should be performed. Catastrophic cervical trauma should be assumed in the player with symptoms or signs referable to cord damage. In the absence of neurological abnormalities, an unstable spinal column injury with potential cord compromise is suggested by significant cervicothoracic pain, focal spinal tenderness, or restricted neck motion.

Any athlete with a suspected cervical spine injury should be carefully immobilized and prepared for transport. Once the decision to transport has been made, the face mask should be carefully removed.

In preparation for transport, the athlete should be immobilized on a backboard. Emergency medical personnel should be briefed regarding the injury and the patient’s current status and examination findings. During transport, ongoing assessment of the patient’s vitals, mental status, and neurological status is important.

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