Mike Dickinson describes the results of an audit undertaken to develop guidelines on neck injury management

Patients who present at the triage area of the A&E department with neck pain following trauma need to be assessed in a methodical and accurate manner. Many patients will be subsequently discharged with little or no interventions, but potential ‘occult’ type injuries need to be detected early. There are many anecdotal histories of patients walking into casualty with a ‘broken neck’, but in the absence of nationally accepted guidelines, nurses may be left in a dilemma when assessing such clients.