# 高速車禍後可能頸椎損傷之34歲病人。初期外傷急救之適當處置?複選。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375027&lang=zh-tw  
> language: zh-TW  
> subject: Pharmacological and Parenteral Therapies  
> category: PPT

## 題目

高速車禍後可能頸椎損傷之34歲病人。初期外傷急救之適當處置?複選。

1

以至少3人logroll檢查背部並移除long board

2

維持頸圈同時施行徒手中線穩定

3

移除頸圈以便評估氣管偏移

4

以jaw thrust代替head tilt-chin lift開放氣道

5

臨床解除前依NEXUS或Canadian C-Spine準則安排影像

## 解析

疑頸椎損傷:徒手中線穩定、以jaw thrust開放氣道、3-4人logroll檢查背部、以NEXUS或Canadian C-Spine加影像確認後再解除。頸圈僅於臨床與影像確認後移除 — 不得為方便檢查而移除。Long board長時間易壓瘡,移至床上後盡早移除。

## 深入解析

NEXUS低風險:無後中線壓痛、未中毒、意識正常、無局部缺損、無轉移注意之傷害 → 可不需影像即臨床解除。

## 臨床情境

GCS 13、抱怨頸痛、無局部缺損。已戴頸圈。生命徵象穩定。

## 重要概念

- **中線穩定** — 以徒手將頭部維持中線以限制頸椎活動。
- **Jaw thrust** — 不伸展頸部之提起下顎開放氣道手法。
- **NEXUS準則** — 頸椎低風險臨床解除之決策準則。

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