(12) There are signs of vasodilation (widening of the blood vessels allowing
increased blood flow).
(13) The patient has a gunshot wound between the neck and the pelvis.
b. Additional Clues. Suspect spinal cord injury if the patient has any of the
(2) Lacerations (wounds made by a tearing of the tissue) to the
face/forehead (due to cervical hyperextension).
Scalp lacerations (could be caused by compressions or fracture of the
(4) Abrasions (superficial injury in which skin or mucous membrane is
scraped away) of the back of the neck or upper thorax (due to flexion injury to the dorsal
(5) Fractured mandible (jawbone) or associated contusion or abrasion about
the jaw (associated with rotational injury to the spine).
Calcaneal injury (heel bone), thoracic, and lumbar compression fracture.
Abdominal bruises (lumbar fracture).
5-16. GENERAL ASSESSMENT
Make a quick but complete assessment at the scene of the accident. Do this to
determine the extent of injury to the patient. Set up priorities for care because any life-
threatening condition requires immediate care. As you observe the patient, find out the
history of the accident.
a. Mechanism of Injury. Determine how the injury occurred. Ask the patient if
he is conscious and alert. Ask witnesses and examine the accident site.
b. Exact Time of Injury. Try to determine the exact time the patient was
c. Sensations Felt by Patient. Does the patient feel pain, weakness,
numbness, paralysis, or tingling?