It is important to remember that spinal shock can cause hypotension, paradoxical bradycardia, and warm, dry skin. However, consider all causes of shock in an athlete who might have multiple fractures. A tension pneumothorax, especially in tall, thin athletes, may also cause hypotension with paradoxical bradycardia. It is also important to gauge cervical tenderness by palpating the spinal processes for tenderness and the paraspinal musculature for tenderness and spasm. This can also be done on the sideline.
Complete injury renders the patient without motor power or sensation below the level of injury.
Incomplete injury leaves the patient with some preserved motor or sensory function. Although rare, a complete injury results in a poor outcome in almost all cases. Finally, if a serious injury is visually obscured, it may be necessary to expose the area by removing clothing or equipment without moving the patient. If the patient is alert, the history is at least as important as the physical exam. History taking can be included during initial trauma management or be done immediately afterward.