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← Head and Spine Injuries

EMT Basic · Chapter 29 · Review · Chapter track

Head and Spine Injuries

Referencing the content of EMT-Basic training and emergency patient care

Learning objectives (15)

  1. Define traumatic brain injury (TBI) — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  2. Demonstrate how to perform a jaw-thrust maneuver on a patient with a suspected spinal injury — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

  3. Describe the anatomy and physiology of the nervous system, including its divisions into the central nervous system (CNS) and peripheral nervous system (PNS) and the structures and — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  4. Describe the different types of brain injuries and their corresponding signs and symptoms, including increased intracranial pressure (ICP), concussion, contusion, and injuries caus — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  5. Describe the different types of injuries that may damage the cervical, thoracic, or lumbar spine; include examples of possible MOIs that may cause each one — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  6. Discuss age-related variations that are required when providing emergency care to a pediatric patient who has a suspected head or spine injury — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

  7. Explain emergency medical care of a patient with a head injury; include the three general principles designed to protect and maintain the critical functions of the CNS and ways to — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

  8. Explain the difference between a primary (direct) injury and a secondary (indirect) injury; include examples of possible MOIs that may cause each one — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  9. Explain the different circumstances in which a helmet should be left on or taken off a patient with a possible head or spinal injury — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

  10. Explain the different types of head injuries, their potential mechanism of injury (MOI), and general signs and symptoms of a head injury that EMTs should consider when performing a — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  11. Explain the functions of the somatic and autonomic nervous systems — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  12. Explain the steps in the patient assessment process for a person who has a suspected head or spine injury; include specific variations that may be required as related to the type o — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  13. List the MOIs that cause a high index of suspicion for the possibility of a head or spinal injury — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

  14. List the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system — Knowledge/skills objective (printed page 1039); confirm wording in your course copy.

  15. List the steps EMTs must follow to remove a helmet, including the removal of a football helmet — Knowledge/skills objective (printed page 1040); confirm wording in your course copy.

Chapter web resources

Optional reading from authoritative sites. Your textbook remains the primary source for this course.

When sources disagree (5 topics to verify before you teach from this chapter alone)

Printable study sheetPrintable flashcards (PDF, 10-up)Read first, then practise the track.

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Vocabulary · 14

  • Traumatic brain injury (TBI)

    An injury to the brain caused by external force — ranging from mild concussion to severe brain damage.

    SourceCDC — Traumatic brain injury basics

  • Concussion

    A mild TBI marked by transient neurologic symptoms — confusion, headache, brief loss of consciousness — without structural brain injury on imaging.

    SourceCDC — Concussion basics

  • Contusion (cerebral)

    Bruising of brain tissue from blunt impact, with localized bleeding and swelling.

    SourceAmerican Association of Neurological Surgeons (AANS) — Cerebral contusion

  • Coup-contrecoup injury

    Brain injury occurring both at the site of impact (coup) and on the opposite side from rebound (contrecoup).

    SourceAmerican Association of Neurological Surgeons (AANS) — Coup-contrecoup injury

  • Epidural hematoma

    Bleeding between the skull and dura mater, often arterial, classically with a lucid interval followed by rapid deterioration.

    SourceAmerican Association of Neurological Surgeons (AANS) — Epidural hematoma

  • Subdural hematoma

    Bleeding between the dura and brain, typically venous; can develop acutely or chronically, especially in older adults on anticoagulants.

    SourceAmerican Association of Neurological Surgeons (AANS) — Subdural hematoma

  • Intracerebral hemorrhage

    Bleeding directly into brain tissue from a ruptured vessel.

    SourceAmerican Stroke Association — Hemorrhagic stroke

  • Intracranial pressure (ICP)

    The pressure inside the skull; sustained elevation reduces brain perfusion and worsens brain injury.

    SourceAmerican Association of Neurological Surgeons (AANS) — Intracranial pressure monitoring

  • Cushing's triad

    A late sign of increased intracranial pressure — rising blood pressure, falling pulse, and irregular respirations.

    SourceMerriam-Webster Medical Dictionary — Cushing's triad

  • Spinal motion restriction (SMR)

    Keeping the spine in neutral alignment when injury is suspected; selectively applied per current evidence.

    SourceNAEMT / ACS-COT joint position statement — Spinal motion restriction

  • Neurogenic shock

    Distributive shock from loss of sympathetic tone below a spinal cord injury, producing hypotension with bradycardia and warm skin.

    SourceAmerican Association of Neurological Surgeons (AANS) — Spinal cord injury — neurogenic shock

  • Spinal shock

    A transient loss of reflex activity below a spinal cord injury that typically resolves over hours to weeks.

    SourceAmerican Association of Neurological Surgeons (AANS) — Spinal shock

  • Decorticate posturing

    Abnormal posture with arms flexed, fists clenched, and legs extended — indicates injury at or above the upper brainstem.

    SourceNIH MedlinePlus — Decorticate posture

  • Decerebrate posturing

    Abnormal posture with arms extended and rotated outward — indicates more severe brainstem injury and worse prognosis than decorticate.

    SourceNIH MedlinePlus — Decerebrate posture

Sequences · 2

  • Spinal motion restriction in a suspected spine-injured patient — Order the EMT actions for spinal motion restriction.
  • Cushing's triad as ICP rises — Order the three components of Cushing's triad as intracranial pressure becomes critical.