If patient comatose:
1. Rub sternum with knuckles
2. If all extremities move, severe injury unlikely
3. If one side moves and other does not, potential hemiplegia
4. If arms move and legs do not, lower spinal cord injury
Administer steroids as ordered
Assist with application of skull tongs - Vinke or Crutchfield
Maintain IV infusions
Insert Foley as indicated
Assist with dressing of open

Condition	Assessment: Signs and Symptoms	Prehospitalization Nursing Care	In-hospital Nursing Care
			Check for level of injury and function, asking patient to: Lift elbow to shoulder height (C-5) Bend elbow (C-6) Straighten elbow (C-7) Grip your hand (C-8-T-1) Lift leg (L-3) Straighten knee (L-4, L-5) Wiggle toes (L-5) Push toes down (S-l) If patient comatose: Rub sternum with knuckles If all extremities move, severe injury unlikely If one side moves and other does not, potential hemiplegia If arms move and legs do not, lower spinal cord injury Administer steroids as ordered Assist with application of skull tongs - Vinke or Crutchfield Maintain IV infusions Insert Foley as indicated Assist with dressing of open
Chest injuries			Note color and pattern of respirations, position of trachea Auscultate lungs and palpate chest for: crepitus, pain, tenderness, and position of trachea Place gauze soaked in petroleum jelly over open pneumothorax (sucking chest wound) to seal hole and decrease respiratory distress Assist with tracheostomy if indicated Prepare for insertion of chest tubes if pneumothorax or hemothorax present