Emergent Care

Realistically, a neurologist is likely to be involved in management of an acute CNS trauma patient as a part of a larger team that should necessarily include an emergency physician. As a result, the most important points of approach are not those at the scene of the accident but rather upon hospi-talization. Basic knowledge of the principles of management of any obvious or potential CNS injury is valuable. On the scene, the circumstances of the accident or injury should be assessed quickly, and any potential risk of CNS injury identified alongside the rest of the injuries in order to help guide appropriate care. It is often stated that the patient should be moved as little as possible, especially for patients who suffered machinery-related injuries. Most importantly, the patient's neck (and the rest of the spine) should not be hyperextended, hyperflexed, or rotated. Use of spinal boards and neck immobilizers is very important; they should be made readily available to medical personnel and, in the agricultural setting, other educated and capable individuals (1,4).

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