Citation

Vanegas JC, Jones D. J. Am. Coll. Emerg. Physicians Open 2022; 3(6): e12829.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1002/emp2.12829

PMID

36570371

PMCID

PMC9767856

Abstract

A 54-year-old man was involved in a high-speed motor vehicle collision where the patient was struck on the driver's side. The patient was found unresponsive and without pulses by emergency medical services who started advanced cardiac life support (ACLS) and placed a supraglottic airway. The patient arrived at the emergency department in pulseless electrical activity arrest, and ACLS was resumed. Multiple rounds of cardiopulmonary resuscitation were performed, multiple rounds of epinephrine were administered, and bilateral chest tubes were placed. Return of spontaneous circulation was obtained after ≈25 minutes. The secondary survey was notable for edema and mottling of the skin of the face, a hematoma over the left side of the neck with accompanying seatbelt signs, absence of cervical spine step-offs or deformities, and absence of sphincter tone. Computed tomography pan scan was notable for complete dissociation of C6 from C7 with severe distraction measuring 3.6 cm craniocaudally (Figures 1-3), a large C2 to C3 spinal cord intraparenchymal hematoma with presumed complete cord traction-transection, and a transected and occluded left vertebral artery at the level of the first rib with largely associated hematoma formation within the deep neck at this level with active extravasation...

Language: en