Sore Neck

X-ray of the neck : Photo by Andrew Ciscel

As I mentioned yesterday, my crewmate is, I don't know, sunbathing topless on a French beach or something, so I have brand-new people to work with. And there are a lot of brand new people coming out of training school ready to be scarred for life educated by myself.

Working with someone fresh out of training school is normally quite enjoyable – I can show off, while they can tell me how whatever I'm doing isn't part of current educational theory on pre-hospital care. It's a win-win situation.

The first job I had with the shiny new recruit was a woman who'd fallen downstairs – often a nice and easy job and, as I blue-lighted us towards it, I checked up on what my crewmate knew about such things. As it was she wasn't confident about clinically clearing a neck injury, so I thought this would be a good chance to show her how it is done.

Our patient had fallen the entire length of the stairway, about thirteen steps rolling head over heels down them. She was complaining of neck and shoulder pain but had got herself up off the floor to sit on the sofa.

I'd gone over the finer points of clinically clearing a neck on the way to the patient, so what was left was for me to actually feel down the neck to see if there was any bony tenderness.

Down the bones of the neck I felt – C1, C2, C3, C4, C…. Oh dear, judging by the way she yelped in pain she seems to have a rather sore neck at the level of C5.

A really nice patient (and family) and we were going to have to truss her up like a turkey in order to make sure that her suspected neck injury didn't get any worse.

So that is exactly what we did, c-spine collar, strapped down and as smooth a ride into hospital as I could manage.

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We returned to the hospital a little later and they confirmed that our patient did indeed have a broken neck, it was just then a question of if they were going to treat it conservatively (with a collar), or if she would need surgery.

“You see”, said the doctor to me as I asked about our patient, “anyone with a bony pain in the neck needs to be collared”.

I didn't bother explaining that this is exactly why we had brought her in strapped down and with her neck immobilised.

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I don't know why, but my regular crewmate and I don't do 'trauma' – but as soon as one of us goes on holiday the other is left having more trauma in those few days than we would otherwise have all year.

9 thoughts on “Sore Neck”

  1. I well remember taking part (reluctantly: I was off-duty at the time, relaxing over a pint in the Residences, when some misbegotten oaf went round bashing on doors and coralling all of us who looked out to take part in the event) in one of those Major Incident rehearsals.At one point I had to escort a suspected #cervical spine to X-ray, the volunteer patient duly collared up and forbidden to move.

    We get into X-ray, which is staffed by thoroughly-pissed-off technicians – I think they'd been press-ganged too. One of them looks at the docket, says “Come on mate, help us” to the 'patient' while forcibly yanking his head forward to insert the plate. There was a great hiss from behind us where the observers stood, and one of them pipes up, “Congratulations, you've just killed this patient.” The tech just glowered and muttered “So the fuck what” under his breath. I'm trying to keep a straight face.

  2. Hi Tom, 16 years ago my hubby fell down stairs whilst on holiday,(in a isolated village) he also got up and walked back up the stairs, then felt very unwell! ambulance called and he was transported off in front of ambulance (range rover) with a collar on, xrayed showed a fracture to C4 transferred on a board to a major hospital, took long and painful recovery, still has nerve damage to part of face and neck, and some pain, but hes fine, was retired from his job, a small slip that changed his lifetake care joan

  3. Erm – i may be being really really dense – but is that the broken neck? If so, where's the break? (and don't say C5, I got that bit…)I'm not exactly great at reading X-rays…. There is a reason I did not train to be a radiographer – I did not fancy spending my life sitting in the dark and refusing to make descisions….

  4. I'm no expert… but I think I can see it, where the anterior process of C5 joins the body of the vertebra. Either that or it's a biro mark on my screen… (“,)

  5. Most assuredly a “better safe than sorry” job, then. Many years ago my brother came close to being paralysed after a motorcycle accident. Had a passing off-duty firefighter not stopped them, two witnesses to the accident were about to remove his helmet, which was badly damaged. The paramedics who attended did everything by the book, the helmet was removed (by some green-suit magic trick) without causing further damage and after he'd spent three months in hospital, he was eventually as good as new. The other possible outcome didn't bear thinking about.

  6. I spent ages looking at that X-ray thinking “well I dont see one, what am I missing”!!! Thanks for clearing that up :p

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