A 30-year-old Food Panda rider had a head-on collision with a cement truck. When the paramedic assessed him on arrival, he reported severe pain in his neck and was unable to move his arms and legs. He could not feel his arms and legs. He was drowsy but orientated to his current location.
Vital signs at the scene:
Blood pressure of 100/72 mmHg
Heart rate of 82 per/min
Respirations of 22 per/min.
Pupils equal and reactive to light
Cervical collar applied –
Immobilized head on Ferno Scoop Stretcher.
100% of Oxygen and transported him to the hospital.
Past Medical History
ORIF to Left Trimalleoler fracture 3 years ago.
Single and lives with elderly parents. Older sister married.
On arrival at ED
- Minimal biceps brachii stretch reflexes, with no triceps or wrist extensor reflexes
- All other muscle stretch reflexes in the upper and lower extremities were absent
- Perception of sensory stimuli ended bilaterally at an imaginary line drawn across his chest 1/2 inch above the nipples
- Some sensation in his arms, but could not localize touch or describe texture with any consistency there
- Able to elevate his shoulders and isometrically contract his biceps brachii slightly in each arm, but could not raise either arm against gravity
- Lower extremities were flaccid, despite attempts to move them
- Cervical Spine: Unstable C6 Compression Fracture (Burst Fracture)
- Chest: Mild Pulmonary Oedema
- C6 Lesion with no Vascular Haemorrhages noted but some blood evident at C5-6 with bone fragments in the Spinal Canal
- Mild Frontal Contusion
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