Neck injuries

Penetrating and non-penetrating neck injuries are more likely to damage the carotid than the better protected vertebral artery. The vertebral artery appears to be more vulnerable to rotational and hyperextension injuries of the neck, particularly at the level of the atlas and axis. Laceration, dissection and intimal tears may be complicated by thrombosis and then embolism and, therefore, ischemic stroke at the time of the injury or some days or even weeks after the injury. Later stroke may be a consequence of the formation of a traumatic aneurysm, arteriovenous fistula or a fistula between the carotid and vertebral arteries (Davis and Zimmerman 1983). 

Any injury in the days and weeks before ischemic stroke or TIA onset is important and may not be spontaneously volunteered by the patient particularly where this occurred some time previously. A head or neck injury might have caused a chronic subdural hematoma (highly unlikely if more than three months previously) or carotid or vertebral dissection (Ch. 6). 

Facial and neck injuries may predispose the victim to airway and ventilatory difficulty. Airway compromise may result if the patient with facial fractures remains in a supine position due to lack of bony support. Progressive airway obstruction may also result from hemorrhage from penetrating neck wounds. Bleeding into the trachea, bronchus, and lungs will all compromise the victim s airway and ventilatory status. An artificial airway should be placed to maintain airway patency until intubation is required (American College of Sur-... 

Similar stories abound in magazines and newspapers. Larry Feldstein, a former New York City high school teacher, collects 3,300 a month tax-free in a disability pension, yet bills himself as a skilled and graceful ski pro who can execute the perfect turn. On a Mount Snow (Vermont) Web site, Feldstein calls himself a Perfect Turn Ski Pro who is also a certified senior fitness trainer. Feldstein retired in 1994 as a swimming and physical education teacher and was granted a disability pension, ostensibly because he had suffered a neck injury while demonstrating a hockey shot in April 1992. Three doctors on the system s medical board approved the disability. ... 

Eye movements to command or to the doll s head maneuver (if no suspicion of neck injury)... 

Optimize the airway position to force the flaccid tongue fon[Pg.1]

Head Injury Mechanisms Neck Injury Mechanisms... 

Thomas, D.J. and Jessop, M.E. 1983. Experimental head and neck injury. InC.L. Ewingetal. (Eds.), Impact Injury of the Head and Spine, pp. 177-217. Springfield, IL, Charles C Thomas. 

Jakobsson, L. 2004. Evaluation of impact severity measures for ais 1 neck injuries in frontal impacts using crash recorder data. International Journal of Crashworthiness 9(1), 105-111. 

Kullgren, A., Kraffl, M., Nygren, A. Tingvall, C. 2000. Neck injuries in frontal impacts Influence of crash pulse characteristics on injury risk. Accident Analysis and Prevention 32(2), 197—205. 

The most common neck injury is caused by rearward flexion and forward extension ( whiplash ), which may result in dislocation or fracture of the cervical vertebrae, and compression of the spinal... 

Don t move the victim If there is any chance of spine or neck injury do not move the victim unless he or she is in a life-threatening situation. 

Look for signs of life Look for signs of life and give artificial respiration or CPR if necessary but only if you have been trained. Be sure help is on the way before starting CPR. Do not tilt the victim s head back if you suspect a neck injury. 

In adults, the morbidity rate in pelvic trauma ranges between 5% and 15% but may reach 50% in some cases. In 12% of cases, the death is attributable to the pelvic trauma. In children, the death rate is lower (SiLBER et al. 2001) and the morbidity mostly the result of associated head and neck injuries. 

With radial neck injuries where the angulation is up to 30°, a non-operative approach is usually employed as this will normally remodel and does not require intervention (Schmittenbecher et al. 2005). 

La Prade RF, Burnett QM, Zarzour R, et al. (1995) The effect of the mandatory use of face masks on facial lacerations and head and neck injuries in ice hockey. Am J Sports Med... 

Her physical examination was unremarkable for any problems other than findings related to the neck injury. The posterior neck musculature was tense and tender to palpation. Motion was grossly restricted in flexion, side-bending, and rotation bilaterally. There was some muscle tension and tenderness in the upper back to about the level of T4. A neurologic examination was normal. The cranial rhythm was sluggish and there was a tendency toward a right side-bending dysfunction of the basi-occiput. 

Contraindications for HFCWO are mostly the same as for IPV, plus head or neck injury not yet stabilized, burns, open wounds, infection or recent thoracic skin grafts, osteoporosis, osteomyelitis, coagulopathy, rib fracture, lung contusion, distended abdomen, and chest wall pain (6,93). 

The way the task is presently being performed, the worker is at risk for MSD injuries involving the shoulder, wrist, baek, and possibly the neck. Injuries such as these can pose a serious threat to workers and costs companies in lost time and worker s compensation claims. 

IIHS (1999). Neck injuries in rear-end crashes. Status Report Special Issue (Insurance Institute for Highway Safety), 34,1-11. 

Another special mask, first requested in 1940 and again by the Chief Surgeon, ETO, in 1944 was the headwound mask, for soldiers in field hospitals with head, face, jaw, or neck injuries. It consisted of a vinylite hood... 

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