Out-of-hospital cardiac arrest due to cervical spine injury by uncertain trauma: A study of two cases

Abstract

Cervical spinal cord injury is a well-known cause of cardiac arrest in trauma victims. Unless trauma is definitively suspected, emergency medical services teams perform resuscitation in the pre-hospital stage without cervical spine immobilization. During advanced cardio-vascular life support (ACLS), intubation with cervical spinal immobilization causes difficulty in accessing the airway, thus, immobilization tends to not be performed, unless the patient is a clear case of trauma. We report two patients with out-of-hospital cardiac arrests (OHCA) due to cervical fractures that have occurred without clear trauma. In these cases, pre-existing cervical spine lesions was ad-ditional informed and identification of the cervical spine fractures was delayed. Emergency medical physicians tend to neglect cervical spine injury when the likelihood of trauma is unclear in a patient presenting with OHCA. These cases urge physicians to consider the possibility of cervical spinal injuries, even in cases of minor trauma. If there is a possibility of cervical spinal injury, imaging should not be delayed and should be followed by appropriate treatment.