NREMT Paramedic Cognitive ExamTraumaMedium
A 30-year-old male sustained a fall from a height of 15 feet, landing on his feet. He complains of severe bilateral heel pain and lower back pain. Which of the following spinal injuries should the paramedic be most concerned about?
- AThoracic spine fracture
- BLumbar spine compression fracture
- CCervical spine fracture
- DSacral fracture
Show answer & explanationAnswer & explanation
Correct answer: B. Lumbar spine compression fracture
A fall from a height landing on the feet transmits axial loading forces up the kinetic chain. This mechanism commonly results in calcaneal fractures and compression fractures of the lumbar spine, specifically L1 or L2, due to the force transmission.
Why the other options are wrong
- A. Thoracic spine fractures can occur but are less common with this specific mechanism than lumbar, which is directly above the pelvis.
- C. While possible, direct axial loading from landing on feet is less likely to cause isolated cervical spine fracture compared to lumbar.
- D. Sacral fractures are less common with this mechanism compared to lumbar spine compression fractures.
Axial Loading Spinal Injury
Spinal injury resulting from a compressive force applied along the long axis of the spine, often seen in falls where the person lands on their feet or buttocks.
- Commonly causes compression fractures.
- Lumbar spine is a frequent site of injury (L1-L2).
- Often associated with calcaneal fractures.
Memory trick: Feet First Fall: Lumbar's Last Stand.