Case of the Month #38 Spinal Cord Injury

Published 27/04/2023

Why might patients with a high C-spine injury following trauma develop respiratory compromise?

  • Loss or interruption of phrenic nerve function (if the lesion is above C5 the phrenic nerve, and therefore the action of the diaphragm, may be affected).  Lesions above C5 may necessitate ventilatory support 

  • Direct trauma to the head and neck from concurrent trauma 

  • Loss of airway reflexes secondary to reduced level of consciousness 

If there is any evidence of respiratory compromise, consideration should be given to securing the patient’s airway using inline c-spine stabilisation to prevent any further secondary spinal cord injury.  The patient must maintain in-line stabilisation and log rolls etc until definitive fixation has occurred.