study_ing
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in a pt with head trauma and epistaxis
but no focal signs or change in mental status
do we go for a CT head first or cervical spine x ray ( ct head with cervical is not an option given'
will appreciate any discussion
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| ssrpk
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head trauma presentation can be very innocuous yet subtle which is not the case with cervical fractures or cord compression!
it is routine protocol in head trauma cases to evaluate cervical Xray as well as CT but i guess with epistaxis, CT should be performed first as CSF otorrhea may be masked by epistaxis.
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| study_ing
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thanx 
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| chemamr
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as the pt looks like stable but with a likely cranial fracture, i would go with a head CT as well.
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| mimi222
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i think that to answer this question they should give you something more in senario.for example warning symptomes signs of intracranial bleeding.if there is not warning signs usually there is no need for head ct but if you are suspitious about the cervical spine injury because of the mecanism of trauma or tenderness on cervical spin you should alwaya take a neck xray.i would go for a lateral neck xray.
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