Last Updated on July 27, 2022
History Taking
Background
• Premorbid ADL status
• Hand dominance
• Occupation
• Comorbidities
• Staying with who?
• How patient came? Brought by ambulance? Came alone?
Trauma details
• Date & time of trauma
• Witness
• How trauma occurred?
• Type of trauma
• Was patient under alcohol or illicit drug influence?
Motor-vehicle accident
• Type of vehicle
• Patient was the driver / passenger / rider / pillion rider ?
• How it happened?
• Speed
• Wearing helmet? Helmet intact?
• Did the vehicle hit anything e.g. divider?
Post-Trauma
• Pain at which site?
• Bleeding at which site?
• Abrasion wound at which site? Laceration wound at which site?
• Able to walk?
• Any headache? Any vomiting?
• Any loss of consciousness? How long it lasted?
• Any retrograde amnesia?
Relevant History
• Co-morbidities e.g. DM, HTN,
Physical Examination
• Trauma survey – [open]
Criteria
(a) High Energy Impact
(i) Falls
• >6 meters (≈double-storey)
(ii) High-risk auto-crash
• Intrusion: >30 cm from occupant site or >46 cm from any site
• Ejection: partial / complete, from vehicle
• Death in the same passenger compartment
• Vehicle telemetry data consistent with high risk injury
(iii) Auto VS pedestrian / bicyclist
(iv) Thrown / run over, or with significant (>30 km/hr) impact
(v) Motorcycle crash >30 km/hr
(b) Canadian CT Head Rule
(c) Nexus criteria for cervical clearance
Investigations
Imaging
• Chest X-rays
• Pelvic X-rays
• CT brain (brain window & bone window)
• CT cervical