A motor vehicle collision subjects the body to intense, sudden forces, causing both obvious and hidden injuries. A systematic medical evaluation is performed following an accident, regardless of how minor the incident seems, to identify all potential trauma. This structured assessment stabilizes the patient, documents all injuries, and provides a foundation for necessary treatment and recovery.
Immediate Life Threat Assessment
The initial medical evaluation focuses on a rapid, standardized protocol known as the Primary Survey, which prioritizes the most fundamental functions for survival. This assessment follows the “ABCDE” mnemonic to identify and treat conditions that could lead to death within minutes. Airway patency is checked first, ensuring the patient can breathe and that the throat is not obstructed, often while maintaining manual cervical spine stabilization.
Breathing is evaluated by checking the respiratory rate, effort, and oxygen saturation, and by listening to lung sounds to detect conditions like a collapsed lung (pneumothorax). Circulation is assessed next, involving checking the pulse, blood pressure, and capillary refill time, while simultaneously controlling any major external bleeding. Control of massive external hemorrhage is often prioritized even before airway management in modern trauma protocols.
Disability refers to a quick neurological check, often using the Glasgow Coma Scale (GCS) to determine the patient’s level of consciousness and responsiveness. Exposure involves fully undressing the patient to look for hidden injuries. Warming blankets are used to prevent hypothermia, which can worsen outcomes in trauma patients.
Spinal and Musculoskeletal Examination
After stabilizing immediate life threats, the medical team conducts a detailed physical examination to assess the body’s structural integrity. This evaluation focuses heavily on the spine, particularly the cervical (neck) and lumbar (lower back) regions, which are susceptible to strain from impact. Doctors check the range of motion by asking the patient to move their neck and back, looking for pain, stiffness, or restricted movement.
Palpation is used to check for localized tenderness, swelling, and muscle spasms along the spine and major muscle groups. This technique is relevant for assessing whiplash-associated disorders. The extremities (arms and legs) are also examined for signs of trauma, including deformity, swelling, or bruising that could indicate a fracture, sprain, or joint dislocation.
Joint stability and muscle strength are tested to ensure ligaments and tendons have not been significantly damaged. The exam also includes a check of peripheral pulses and sensation in the limbs to rule out damage to blood vessels or nerves.
Screening for Internal and Neurological Damage
Beyond the structural evaluation, doctors screen for injuries that may be hidden beneath the surface. A detailed neurological assessment is conducted to look for signs of traumatic brain injury (TBI) or concussion. This involves checking cranial nerve function, evaluating reflexes, and testing cognitive functions like memory and orientation.
The abdomen is examined for signs of internal bleeding or organ damage, which can be life-threatening but initially present with mild pain. Palpation is used to check for firmness or guarding of the abdominal muscles, which can signal underlying injury to organs like the spleen or liver. An abdominal examination may also include listening to bowel sounds and assessing the pelvis.
The chest is evaluated, with the physician listening to the heart and lungs to detect muffled sounds or abnormal rhythms that could indicate a pneumothorax or cardiac contusion. Identifying internal and neurological damage is necessary to prevent delayed complications.
Diagnostic Imaging and Next Steps
To confirm physical findings and search for occult injuries, doctors utilize various diagnostic imaging technologies. X-rays are commonly the first test ordered, providing clear images of bones and joints to quickly identify fractures, dislocations, or spinal instability. They are valuable for ruling out significant skeletal trauma, which guides subsequent patient care.
Computed Tomography (CT) scans offer detailed cross-sectional images. They are frequently used to assess the brain for hemorrhages or skull fractures, and the chest and abdomen for internal organ damage and bleeding.
Magnetic Resonance Imaging (MRI) is often used when soft tissue damage is suspected, such as ligament tears, herniated discs, or spinal cord injury. MRI provides superior detail of non-bony structures. The decision to order a specific imaging test is based on the mechanism of injury, the patient’s symptoms, and the physical exam findings.
Upon discharge, patients are given explicit instructions regarding follow-up care and a list of warning signs that necessitate an immediate return to the hospital. These signs include a worsening headache, persistent nausea or vomiting, new or increasing weakness or numbness in the limbs, and any significant change in mental status.