Return to Scenario ListShow Learning Points most relevant to Phase 1:

Neck injury

Clinical Discipline(s)/Organ System(s)
Emergency Medicine, Ethics, Musculoskeletal System, Neurosurgery, Orthopaedics
Progress Test Topic(s)
Musculoskeletal, Neurological
A 24 year old NZ European female is brought into the Emergency Department after a high-speed motor vehicle crash. She was an unrestrained front-seat passenger. She is thought to have sustained significant head and neck injuries.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Anatomy of the cervical spine and cranium
   - Identify important myotomes and dermatomes
   - Common injury mechanisms and associated fractures of the cervical spine
   - Pathophysiology of spinal cord injuries and neurogenic shock
Clinical and Communication Skills 
   - History from a trauma patient
   - Primary and secondary surveys in trauma and importance of the trauma call
   - Perform a cervical spine examination and focused neurological examination
   - Perform cervical spine immobilisation
   - Indication and timing for trauma series X-rays
   - Interpretation of plain films of the C-spine
   - Indications for CT head, CT neck, CT chest/abdomen/pelvis
   - Management of a multi-trauma patient
   - Indications for intubation, central line insertion and intensive care unit (ICU) admission
   - Preparing a trauma patient for urgent surgery, appreciating risk of anaesthesia with a spinal injury and rapid sequence induction
Personal and Professional Skills 
   - Understand consent and competence
   - Breaking life changing news to to a patient and family/whānau after a major trauma event
   - Principles of best interest and patient advocacy
   - Ethics and life and death decisions
Hauora Māori 
   - Ethnic inequalities in disability whereby Māori have higher rates of disability
   - Impact of socio-economic inequalities for Māori living with disabilities, including remuneration for whānau support
   - Awareness of differential ACC claims and rehabilitation for Māori vs non- Māori
   - Importance of whānau in decision-making
   - Māori perspectives on organ donation
Population Health 
   - Epidemiology of motor vehicle crashes
   - Strategies for preventing road traffic crashes
   - Trauma as a leading cause of death in young people (in developed countries)
   - Chronic acquired disability and ongoing cost of injuries to community
Conditions to be considered relating to this scenario
cervical spine fractures, cervical spine sprains, whiplash, concussion, other multi-trauma injuries
Less common but 'important not to miss'
spinal cord injuries, traumatic brain injury, intracranial haemorrhage, skull and base of skull fractures, distracting injuries
spinal cord injury without radiological abnormality (SCIWORA)