Management of upper cervical spine injuries: a review.

Upper cervical spine injuries are commonly associated with trauma and require significant forces to produce. When these injuries occur they can have devastating functional consequences. The distinctive anatomy of the upper cervical spine leads injuries to occur in predictable patterns. Injuries can occur to the unique osseus structures or ligamentous connections. Common injuries include occipital condylar fractures, atlanto-occipital dislocation, fractures of the ring of C1, ligamentous injuries involving the ring of C1, and the three types of fractures of C2, pars fractures, odontoid fractures and C2 body fractures. We present these common injuries found in the occipital-atlantoaxial complex and their management based on the current and historical literature.

Analysis of the chest X-ray conference in an intensive care unit.

Bed chest X-rays carried out in an Intensive Care Unit (ICU) are an important means of patient monitoring. To get the starting points for standardization of the documentation of X-ray findings, we examined course and contents of the daily X-ray conference in an ICU. We video-taped the conferences and registered its vocabulary.Mean entire duration to comment on the X-rays of one patient was 150 s. On an average, discussion between radiologist and anaesthetist lasted 40 s, dictation of findings 50 s. Sorting and viewing the X-rays took 60 s. Main disruptions were related to non-availability of X-rays and clinical patient data. Clinical information reported during the discussion is rarely mentioned in the dictated findings.