From the Guidelines
A patient with numbness following an injury should be evaluated at the emergency room, especially if the numbness is sudden, severe, or associated with other concerning symptoms, as recommended by the latest clinical policy on evaluating adult patients presenting to the emergency department with acute blunt trauma 1. When considering the evaluation of a patient with numbness after an injury, it is crucial to prioritize potential serious conditions that could lead to significant morbidity, mortality, or impact on quality of life. The clinical policy from the Annals of Emergency Medicine 1 emphasizes the importance of evidence-based recommendations for critical questions in emergency medicine, including the evaluation of patients with acute blunt trauma. Key considerations for emergency room evaluation include:
- Sudden or severe numbness
- Numbness associated with other concerning symptoms such as weakness, loss of bladder or bowel control, difficulty speaking, or facial drooping
- Numbness affecting an entire limb or one side of the body
- Trauma to the head, neck, or spine Given the potential for nerve damage or compression and the importance of timely intervention to prevent permanent disability, prompt evaluation at the emergency room is essential. Physicians can perform appropriate imaging studies and determine if surgery or other interventions are needed, based on the latest clinical guidelines 1.
From the Research
Evaluation of Numbness with Injury
If a patient experiences numbness with an injury, it is essential to evaluate the situation carefully. The patient should be evaluated at the emergency room if the numbness is severe, persistent, or accompanied by other symptoms such as weakness, tingling, or pain.
Importance of Emergency Room Evaluation
- A thorough evaluation and treatment of injuries, including those causing numbness, require in-depth familiarity with emergency medicine 2.
- Peripheral nerve injuries, which can cause numbness, are complex conditions that can lead to sensory and motor function deficits and even long-term disability 3.
- Evaluation and management of peripheral nerve injuries require familiarity with relevant anatomy, pathology, pathophysiology, and surgical principles 4.
Considerations for Evaluation
- The optimal timing for an electrodiagnostic study depends on the clinical question being asked, and important information can be obtained by studies done in the first week after injury 4.
- Proximal nerve injuries are problematic, and decision-making regarding exploration must occur quickly 4.
- Inpatient diagnosis and management of neuromuscular disorders, including those causing numbness, require prompt recognition of clinical and pathologic features to reduce associated morbidity and mortality 5.