Wipeout

When prehospital providers transported this patient to the trauma center, they felt a bit awkward, to say the least. The patient appeared to be intoxicated, and had fallen from approximately three feet. Nevertheless, upon EMS' arrival, the patient was responding only to painful stimuli and was not moving his lower extremities. This prompted EMS to activate the trauma system and treat the patient accordingly: He was immobilized on a long backboard. During transport, however, the patient became responsive to verbal stimuli and began moving his lower extremities. When he was transferred to the ED staff, he appeared to be doing fine neurologically, except for the intoxication. The EMS crew felt a bit embarrassed for the activation of trauma services. Three hours later, however, the ED physician called the providers at their station to inform them that the patient had an unstable cervical spine fracture (see x-ray above), and their care was definitely appropriate.