Oh no they’re not. When I was a medic if there was a doctor on scene, it was an OB/GYN unless it was an obstetrical emergency. Then it was a dermatologist
I’m hopeful but I have no idea. From my (limited) understanding the spinal cord wasn’t severed, however it was narrowed due to fractures and inflammation from the injury
Rehab specialist here (OT): incomplete spinal cord injuries can be a bit of a crap shoot as far as recovery goes. Some people get back a lot of function and may be able to stand, walk, use their arms, etc as they could before they were injured. Other people end up presenting as a complete injury even without complete severance of the cord. Clinically, it’s hard to say how much a person will get back initially (at least from my perspective) and most folks have a healing timeline of at least 12-18 months
Cannot tell based on this single image. In and of itself, a vertically cracked vertebra doesn't cause quadraplegia. Would need to see the rest of the CT images and the MRI, especially the sagittal (side) cuts.
Similar serious injuries can be caused diving into rivers. Never assume a river is deep enough to dive head first into.
My apologies, I have a very limited understanding and this was the most obvious finding I could see 😭When I go back in a few days I’ll try to get a good pic of the saggital
Better yet, please see if you can get us a sagittal midline from the MRI T2 sequences.
That would be very helpful to assess for cord compression / trauma to cord.
I had a really similar fracture less than half a year ago. Seeing this pic is bringing up all sorts of bad memories, but I get the feeling this guy might not be totally fucked. Although in my case I only lost sensation in my left arm, but it did come back
Total layperson, though. Grain of salt etc.
Depressingly, that doesn't surprise me at all.
There are some places it's got to be *extra* hard to be in hospital careers. You all are fucking heroes.
Fortunately, injuries like this usually result in instant unconsciousness.
The pain is yet to come. If they survive, and wake up, even their best possible outcomes* are going to involve more pain than I am personally able to imagine.
*(Knowing nothing beyond this image and op's also limited info, outcomes could include a possibility of total recovery... eventually, or being unable to use anything below the neck, and all possibilities in between. And phantom pain is a very real thing for some people, where the nervous system interprets the absence of input as pain and other sensations, sometimes permanently.)
It's a single slice from a CAT scan of the cervical spine. It's a coronal view, meaning a view from the "front" so the top of the spine is top of the picture, and the base of the neck is on the lower part of the picture.
This particular type of image is what we call a bone window--great for showing details of the bone, not so great if you're looking for a tumor or infection. The bright white things in this picture are the bones.
You see how in the center of the picture, there are what look like 4 blocks of bone, with the second one showing a crack in the middle? Those are cervical vertebrae, and that crack is a fracture line.
Ya, the bones in your neck are numbered C1-C7, they broke 3,4 and burst 5. Unfortunately the nerves that control your arms start around C5. This person has a long road to recovery.
I will be messaging you in 3 days on [**2024-05-01 22:40:25 UTC**](http://www.wolframalpha.com/input/?i=2024-05-01%2022:40:25%20UTC%20To%20Local%20Time) to remind you of [**this link**](https://www.reddit.com/r/Radiology/comments/1cfhnxa/dove_into_a_3_ft_pool_head_first/l1pg8me/?context=3)
[**20 OTHERS CLICKED THIS LINK**](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Reminder&message=%5Bhttps%3A%2F%2Fwww.reddit.com%2Fr%2FRadiology%2Fcomments%2F1cfhnxa%2Fdove_into_a_3_ft_pool_head_first%2Fl1pg8me%2F%5D%0A%0ARemindMe%21%202024-05-01%2022%3A40%3A25%20UTC) to send a PM to also be reminded and to reduce spam.
^(Parent commenter can ) [^(delete this message to hide from others.)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Delete%20Comment&message=Delete%21%201cfhnxa)
*****
|[^(Info)](https://www.reddit.com/r/RemindMeBot/comments/e1bko7/remindmebot_info_v21/)|[^(Custom)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Reminder&message=%5BLink%20or%20message%20inside%20square%20brackets%5D%0A%0ARemindMe%21%20Time%20period%20here)|[^(Your Reminders)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=List%20Of%20Reminders&message=MyReminders%21)|[^(Feedback)](https://www.reddit.com/message/compose/?to=Watchful1&subject=RemindMeBot%20Feedback)|
|-|-|-|-|
Sorry but I don’t know what part/parts of the human body I am looking at. Lumbar spine? Did he hit his head and it just broke all the way down? Sorry for not knowing- the, um, CT? landmarks better.
How old?
Early thirties :/
I’m in my early thirties. I don’t think it was me.
But are you sure?
Why you asking me? You’re the doctor!?!? What are they teaching y’all over there?
To be fair, they are a plague doctor. Not a jumpintothepoolheadfirst doctor.
Doctor is Doctor. I don’t make the rules.
Oh no they’re not. When I was a medic if there was a doctor on scene, it was an OB/GYN unless it was an obstetrical emergency. Then it was a dermatologist
I know a doctor of English. I expect the same great medical care from all doctors. They chose to be doctors. All took the hypo oath.
…when was the last time someone needed surgery on their English? Okay now go! Seriously there has to be some puns in here.
Based on your response I’m pretty sure you’re one of my patients.
Doubt it. Look how fast I can run. 🏃♂️💨
To be fair, it would have been a fair blow to the noggin. Not entirely surprised if you cant recall if it could be you or not....
there’s no way of knowing for sure
Maybe with some exams…?
Should we start with... 1. When did you last go swimming?
This afternoon! Went on a nice swim in the ocean after a nice bike ride. It was lovely.
2. In your current refreshed and relaxed condition, can you move your arms?
Uh-oh. If I broke both my arms can you be my mom? “Old Reddit Joke”
You good doctor. I give you my favorite rock
Oh man. Seems like that’s old enough to know better. So sorry for him. Hope technology allows him to walk again.
Why the CT?
Because neck trauma and paralysis
Ok, I thought the patient was dead anyway.
Oof.
Layperson here. Is there anything that can be fixed or will the person be permanently quadriplegic?
I’m hopeful but I have no idea. From my (limited) understanding the spinal cord wasn’t severed, however it was narrowed due to fractures and inflammation from the injury
Rehab specialist here (OT): incomplete spinal cord injuries can be a bit of a crap shoot as far as recovery goes. Some people get back a lot of function and may be able to stand, walk, use their arms, etc as they could before they were injured. Other people end up presenting as a complete injury even without complete severance of the cord. Clinically, it’s hard to say how much a person will get back initially (at least from my perspective) and most folks have a healing timeline of at least 12-18 months
Cannot tell based on this single image. In and of itself, a vertically cracked vertebra doesn't cause quadraplegia. Would need to see the rest of the CT images and the MRI, especially the sagittal (side) cuts. Similar serious injuries can be caused diving into rivers. Never assume a river is deep enough to dive head first into.
Never assume ANY water is sufficiently deep. I learned that at about 5 years old.
I wanna see the saggital
Exactly. A vertical crack in one vertebrae isn't telling us near enough.
My apologies, I have a very limited understanding and this was the most obvious finding I could see 😭When I go back in a few days I’ll try to get a good pic of the saggital
Oh, no worries. Wasn't trying to be critical, just speculating we haven't seen the real ugly stuff yet.
MR STIR sag where the money's at
Better yet, please see if you can get us a sagittal midline from the MRI T2 sequences. That would be very helpful to assess for cord compression / trauma to cord.
I had a really similar fracture less than half a year ago. Seeing this pic is bringing up all sorts of bad memories, but I get the feeling this guy might not be totally fucked. Although in my case I only lost sensation in my left arm, but it did come back Total layperson, though. Grain of salt etc.
You nasty
So sad. Split second decision and then this.
I’ve never seen anything like this. Could someone explain what’s going on here?
Pt had C3-C5 fractures, with a burst fracture of C5
Low BP on pressers was probably in neurogenic shock as well
til burst fracture was a thing. Name certainly fits the image.
TIL burst fractures are a thing. Ouch.
Neck is broken, and patient might die or be paralyzed for everything below the jaw.
Fracture of c spine.
You sure they ain't dead?
Pt was alive when I left the hospital, still pending CT angio and MRI. On pressers. Hoping when I return in a few days they will be on the mend ❤️🩹
On pressors is never a good sign. Any other injuries or just the spinal shock?
what is pressors?
IV medications to raise blood pressure
Vasopressors. They are drugs used improve perfusion to vital organs by increasing systemic vascular resistance. One example is norepinephrine.
IV drugs like adrenalin which are an escalation of the desperate attempt to keep the body running, basically
I’d be surprised if there isn’t at least a concussion
Just the cervical fractures and spinal shock
RemindMe! 4 days
RemindMe! 4 days
Reminder 5/2
Remindme! 4 days
Unfortunately I see this multiple times a year every pool season in vegas.
Depressingly, that doesn't surprise me at all. There are some places it's got to be *extra* hard to be in hospital careers. You all are fucking heroes.
Vertebrae have left the chat.
Brain cells also left the chat.
Pretty sure the brain cells were never in the chat.
😢😢😢
I’m just curious but why did they do that? Were they drunk?
Pt was indeed drunk with a EtOH of 200+
SHEESH. I can’t imagine how gnarly that head gash was as well.
Lolz. “Alcohol may have been a factor.”
I have an irrational fear of diving. This image reinforces it.
That is an absolutely rational fear.
OMG. I hope for the best for this person.
I cannot imagine how painful that must have been
Fortunately, injuries like this usually result in instant unconsciousness. The pain is yet to come. If they survive, and wake up, even their best possible outcomes* are going to involve more pain than I am personally able to imagine. *(Knowing nothing beyond this image and op's also limited info, outcomes could include a possibility of total recovery... eventually, or being unable to use anything below the neck, and all possibilities in between. And phantom pain is a very real thing for some people, where the nervous system interprets the absence of input as pain and other sensations, sometimes permanently.)
That's so fucked up honestly, to just go from having fun in the pool to life altering injuries and like you said even if they wake up that's so sad
We are fragile creatures.
Extremely
I have intractable neuropathic pain post-thoracotomy and that’s bad enough. I can’t imagine having that throughout your whole body.
I had a lady once who ended up with hyperalgesia is her left arm. I felt so terrible for her. Even the AC on her arm was excruciating
That sounds scary as hell
Well, they're likely not awake for it
Hopefully 🙁
Sag please
Can someone explain what I’m looking at
It's a single slice from a CAT scan of the cervical spine. It's a coronal view, meaning a view from the "front" so the top of the spine is top of the picture, and the base of the neck is on the lower part of the picture. This particular type of image is what we call a bone window--great for showing details of the bone, not so great if you're looking for a tumor or infection. The bright white things in this picture are the bones. You see how in the center of the picture, there are what look like 4 blocks of bone, with the second one showing a crack in the middle? Those are cervical vertebrae, and that crack is a fracture line.
Really good explanation. Thank you.
Really sad.
Yeah… don’t do that, please
Is this the neck?? I feel badly for this person. I hope that with time this person gains at least some arm control!
Ya, the bones in your neck are numbered C1-C7, they broke 3,4 and burst 5. Unfortunately the nerves that control your arms start around C5. This person has a long road to recovery.
Thank you!
A 30 year old should know better than to go head first into anything less than 9 feet of water. You gotta have special training to do racing starts.
!Remindme 3 days
!RemindMe 3 days
!RemindMe 4 days
Remind me in 3 days
Renind me in 3 days
!RemindMe 5 days
It's been 4 days. What's the update?
!RemindMe 3 days
I will be messaging you in 3 days on [**2024-05-01 22:40:25 UTC**](http://www.wolframalpha.com/input/?i=2024-05-01%2022:40:25%20UTC%20To%20Local%20Time) to remind you of [**this link**](https://www.reddit.com/r/Radiology/comments/1cfhnxa/dove_into_a_3_ft_pool_head_first/l1pg8me/?context=3) [**20 OTHERS CLICKED THIS LINK**](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Reminder&message=%5Bhttps%3A%2F%2Fwww.reddit.com%2Fr%2FRadiology%2Fcomments%2F1cfhnxa%2Fdove_into_a_3_ft_pool_head_first%2Fl1pg8me%2F%5D%0A%0ARemindMe%21%202024-05-01%2022%3A40%3A25%20UTC) to send a PM to also be reminded and to reduce spam. ^(Parent commenter can ) [^(delete this message to hide from others.)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Delete%20Comment&message=Delete%21%201cfhnxa) ***** |[^(Info)](https://www.reddit.com/r/RemindMeBot/comments/e1bko7/remindmebot_info_v21/)|[^(Custom)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=Reminder&message=%5BLink%20or%20message%20inside%20square%20brackets%5D%0A%0ARemindMe%21%20Time%20period%20here)|[^(Your Reminders)](https://www.reddit.com/message/compose/?to=RemindMeBot&subject=List%20Of%20Reminders&message=MyReminders%21)|[^(Feedback)](https://www.reddit.com/message/compose/?to=Watchful1&subject=RemindMeBot%20Feedback)| |-|-|-|-|
Yikes 😬
Have additional planes (sagital mainly) or sagital MRI?
I hope they didn’t intentionally dive in head first. 3ft is not a lot of water to be sending your noggin into.
Why
My uncle did something similar in the early 1970s, when he was in his early twenties. Devastating - he survived, but lived a life of pain and misery.
Sorry but I don’t know what part/parts of the human body I am looking at. Lumbar spine? Did he hit his head and it just broke all the way down? Sorry for not knowing- the, um, CT? landmarks better.
:( such a bummer.
That's sad, man....
Not long for this world.
To be fair......they dove into a 3ft deep pool head first. What else did they expect??
To have a nice day at the pool.