(b) Depth of breathing. Observe the depth of the patient's breathing as
you count the patient's respirations. If the respirations are coming from the diaphragm
only, assist in ventilations.
(c) Head/face cuts and/or bruises. Check the patient's head and face
for cuts or bruises. Most patients with cervical spine injuries also have head or facial
(d) Neck abnormalities. Gently palpate the patient's neck for deformity
and tenderness. If the patient is conscious, ask him to tell you if he feels any
tenderness as you palpate.
(e) Chest/abdomen internal injuries. Examine the chest and abdomen
of the patient for signs of internal injury. A patient whose skin is pale, cold, and clammy
and who has tachycardia (abnormally fast heartbeat), may be in hypovolemic shock
(abnormally decreased amount of blood and fluids in the body). Bleeding into the chest
or abdomen are possible causes of such shock.
(f) Priapism (sustained erection). Observe for priapism. Priapism is a
characteristic sign of spinal cord injury.
(g) Control of elimination. Note any signs of loss of bowel or bladder
(h) Spinal area check. Log roll the patient (turning the body as one
unit, and check the spinal area for deformity or pain.
1 Examine the patient's back for any swelling or hematoma over
the spinal area. Either of these signs would indicate the presence of a bony fracture.
2 Look for a spasm in paravertebral muscles. A curvature of the
spine often indicates such spasms.
3 Look for any open injuries involving the spinal column. Cover
any such injury with a sterile dressing.
b. Neurologic Examination. The purpose of a neurologic assessment is to
furnish data about the exact condition of the patient when he was first seen. Later, any
changes in the patient's condition may be evaluated, and the course of further treatment
determined. The neurologic assessment is NOT to decide whether or not to immobilize
Check the spinal nerve tracts for position, pain, and movement.