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Case No. 191

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Pedestrian S...

Pedestrian Struck By Car

Clinical Scenario
A 32 year old female is brought in by ambulance after being struck by a car while crossing the road. The patient fell onto her left side and hit her head on the hood of the car, but did not lose consciousness. The patient was ambulatory at the scene. Her only complaint is a mild headache, with no nausea, no vomiting, no neurological deficits such as paresthesias or weakness. En route to the emergency department she is placed in a cervical collar, her vital signs are: HR 80, BP 110/70, RR 14, Oxygen saturation: 99% on room air. The patient denies drinking alcohol or using any drugs. She is not taking any medications and is otherwise healthy. On exam, the patient does not have external signs of injury. She complains of neck pain, however no midline spinal tenderness.
Question
Does this patient still need her cervical collar?
  • Obtain CT scan of the cervical spine to determine if she has any injury
  • You can clinically clear this patient’s cervical spine
  • Observe the patient for any developments of neurological deficits
  • Obtain a complete neurological exam, and take of the cervical collar if the exam is normal
  • Question
    Does this patient still need her cervical collar?
  • Obtain CT scan of the cervical spine to determine if she has any injury
  • You can clinically clear this patient’s cervical spine
  • Observe the patient for any developments of neurological deficits
  • Obtain a complete neurological exam, and take of the cervical collar if the exam is normal
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