In a trauma situation, it may be difficult to assess at first evaluation the extent of injuries to the cervical spine. The neck should be immobilized until x-rays are taken and reviewed by a physician. Emergency medical personnel will assume that an unconscious individual has a neck injury and respond accordingly. The victim may experience shock and either temporary or permanent paralysis.
At the accident scene, first check vital signs, including the patient’s consciousness, ability to breathe, and heart rate. After these are stabilized, workers will assess obvious bleeding and limb-deforming injuries. Once the trauma team has stabilized all other life-threatening injuries, the doctor can evaluate the injury.
Conscious patients with an acute neck injury may or may not have severe neck pain. They may also have pain spreading from the neck to the shoulders or arms, resulting from the vertebra compressing a nerve. There may be some bruising and swelling at the back of the neck. The physician will perform a complete neurological examination to assess nerve function and may request additional radiographic studies, such as MRI or computed tomography (CT), to determine the extent of the injuries.