A patient with suspected C5 spinal cord injury is brought to the Emergency Department. They present with flaccid paralysis of their upper extremities and complain of difficulty breathing. Which initial intervention is MOST appropriate to ensure the patient's safety and prevent further injury?
Administer high-dose methylprednisolone within the first hour of injury to reduce inflammation.
Assess and support airway and breathing, preparing for potential ventilatory support.
Maintain immobilization with a hard collar and spine board, awaiting radiographic evaluation.
Provide IV analgesia to manage pain and prevent shock from severe pain.
In a patient with a suspected spinal cord injury at the C5 level, maintaining airway and breathing is critical due to the high risk of respiratory failure. These patients often have diaphragmatic breathing but can quickly fatigue and hypoventilate. Therefore, the most appropriate initial intervention is to assess and support the patient's airway and breathing, potentially providing ventilatory support. Administering high-dose methylprednisolone is no longer recommended due to lack of evidence for significant long-term benefit and associated risks. Immobilization is important, but the immediate life-threat in high cervical spine injuries revolves around airway and respiratory compromise. Analgesia and fluids are important supportive measures but do not address the immediate life-threatening concerns.
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Neurological Emergencies
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