Question

Emergency treatment of the client with cervical trauma focuses on reducing the risk of further injury. What action should be taken before moving the client? A. Applying a cervical collar B. Tilting the head to open the airway C. Assessing motor ability D. Placing the client on a spinal board

Short answer

Answer: A. Applying a cervical collar.

Step-by-step solution

Option A: Applying a cervical collar

Applying a cervical collar can help stabilize the neck and cervical spine area, preventing further injury to the spinal cord. This is a priority in emergency treatment, as it can help prevent further complications and potentially save the client's life.

Option B: Tilting the head to open the airway

Although ensuring an open airway is crucial in emergency treatments, tilting the head to open the airway may cause more harm to the client with cervical trauma as it can put pressure on the injured area leading to potential spinal cord damage. Therefore, this option should not be prioritized before moving the client.

Option C: Assessing motor ability

Assessing motor ability could be relevant in understanding the extent of the cervical trauma. However, that information would not provide immediate assistance in safely moving the client or prior to moving the client. So, it should not be prioritized over stabilizing the cervical spine.

Option D: Placing the client on a spinal board

Placing the client on a spinal board is important for moving a person with potential spinal injury safely. However, before placing the client on a spinal board, stabilizing their cervical spine area should be considered the priority. Based on the analysis of each option, the correct answer is: A. Applying a cervical collar

Key concepts

Cervical Collar Application

Cervical collar application is a critical first step in managing a patient with suspected cervical spine injury. Its main purpose is to immobilize the neck, which helps in reducing the risk of further injury to the spinal cord during movement or transportation. It's essential that the cervical collar is fitted properly; an incorrect fit can cause additional harm or discomfort.

In an emergency context, the application should be gentle yet swift, ensuring that the collar is not too tight to compress the airway, nor too loose to compromise immobilization. Healthcare providers should be competent in this skill, as it's often a lifesaving intervention.

• Gentle manual stabilization of the head is initially applied.
• A properly sized collar is selected based on the patient's anatomy.
• The collar is carefully placed around the neck without forcing the head into any extreme positions.

Training and regular drills in collar application are recommended for all first responders and nursing staff.

Spinal Injury Stabilization

When treating any potential spinal injury, stabilization is imperative. The goal is to preserve neurological function by preventing movement that could cause further injury. Alongside the cervical collar, a spinal board is often used for this purpose, which provides rigid support to the entire spine.

This step is often completed after the cervical collar has been applied. It is critical to move the patient as one unit to avoid any bending or twisting movements that could exacerbate the injury. Techniques such as the log roll are practiced to ensure safe maneuvering of the patient onto the spinal board.

• Careful coordination among the emergency response team is required.
• Use of additional restraints on the spinal board to secure the patient.
• Frequent reassessment for signs of neurological deterioration throughout the stabilization process.

Stabilization devices and methods should be a central component of emergency training for all healthcare professionals.

Open Airway Procedures

Maintaining an open airway is essential in any emergency situation, but it requires special consideration in the presence of cervical trauma due to the risk of further injury. The standard head-tilt-chin-lift method for airway clearance is contraindicated here. Instead, other techniques such as the jaw-thrust maneuver without extending the neck should be used to avoid exacerbating a spinal injury.

The jaw-thrust maneuver is best performed by experienced personnel since it can be difficult to carry out effectively. This involves lifting the jaw forward without moving the head or neck, effectively opening the airway.

• High-flow oxygen may be required to ensure adequate oxygenation.
• If a patient is unconscious and airway compromise is suspected, immediate action must be taken to secure the airway, possibly including intubation with cervical spine precautions.
• Continuous monitoring of oxygen levels and breathing is a standard part of post-intervention care.

Students and care providers should become very familiar with open airway procedures for cervical trauma through simulated practice and hands-on training.

NCLEX-PN Exam Preparation

Preparing for the National Council Licensure Examination for Practical Nurses (NCLEX-PN) requires understanding and proficiency in a wide range of topics, including emergency procedures like cervical trauma management. Prospective nurses must be equipped with knowledge of the initial steps to take following such injuries.

Important concepts include:

• Application and types of cervical collars.
• Knowledge of spinal immobilization techniques and devices.
• Recognition of appropriate airway procedures in different emergency scenarios.

A thorough study plan that combines theoretical learning with practical application through clinical hours and simulation is crucial for success on the exam. Regular review sessions, practical demonstrations, and mastery of emergency protocols are advisable strategies for exam preparation. Engaging with these topics deeply will not only assist in passing the NCLEX-PN but will also lay the groundwork for competent and confident nursing practice.