Emergency Nursing & Triage Q 23 - Gyan Darpan : Learning Portal
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Wednesday, 23 March 2022

Emergency Nursing & Triage Q 23

When attending a client with a head and neck trauma following a vehicular accident, the nurse’s initial action is to?
    A. Provide oxygen therapy
    B. Initiate intravenous access
    C. Immobilize the cervical area
    D. Do oral and nasal suctioning

Correct Answer: C. Immobilize the cervical area

Clients with suspected or possible cervical spine injury must have their neck immobilized until formal assessment occurs. Maintain cervical spine spinal immobilization and minimize neck movement particularly during transport. Beware that absence of neurologic findings does not eliminate the possibility of spinal cord injury.

Option A: Immediate measures are necessary to maintain breathing and hemodynamic stability, such as oxygen therapy. Hyperbaric oxygen (HBO) therapy has also been shown to exert neuroprotective effects when administered before or after SCI. Experimental studies have revealed various mechanisms that contribute to these neuroprotective effects, including improved spinal cord oxygen tension, decreased apoptosis, reduced inflammation, attenuation of oxidative stress, and improved angiogenesis and autophagy.
Option B: Rapid infusion as quickly as possible of large volumes of crystalloids to restore blood volume and blood pressure is now the standard treatment for patients with combined traumatic brain injury and hemorrhagic shock. The final goal of fluid management is to optimize the circulatory system to ensure the sufficient delivery of oxygen to organs.
Option D: Suctioning is also done after the cervical spine is immobilized. Patients with known or suspected cervical spine injury may require emergent intubation for airway protection and ventilatory support or elective intubation for surgery with or without rigid neck stabilization (i.e., halo).

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