emergency management; spinal cord injury

SPINAL CORD INJURY: EMERGENCY MANAGEMENTBy: Joanna Kristal Remollino, Staff Nurse

SPINAL CORD INJURY

A TRAUMA

INCOMPLETE / COMPLETE

TETRAPLEGIA VS PARAPLEGIA

CLASSIFIED using ASIA Impairment scale

(A, B, C, D and E)

Causes

OBJECTIVE

Tp prevent further trauma

To observe symptoms of progressive neurologic deficits

To improve breathing pattern and airway clearance

To improve mobility

To improve sensory and perceptual awareness

To relieve urinary retention

To improve bowel function

absence of complications

Promote comfort

POLICY1. Assessment of patient with spinal cord injury

patent airway

location and severity of cord damage

neurologic level of injury

vital signs

2. Injuries to the spinal column

transient concussionContusion

Laceration

Compression of cord substance

Complete transection of the cord

3. Unconscious patient that is a victim of accident must be considered to have a spinal injury

4. Unconscious trauma patient and with possible SCI must be immobilized

5. Signs and symptoms

Cervical

Thoracic

Lumbosacral

Other syndromes of incomplete cord injury

-central cord syndrome, anterior cord syndrome, Brown-Sequard syndrome, Posterior Cord syndrome

Materials and Equipments

Diagnostics

Xray

MRI

CT SCAN

management

S uspicious Mechanism

P AIN

I ntoxication of any kind that may contribute to the injury

N umbness

A ny distracting/ painful injury that suggest massive trauma

L evel of consciousness

R U L E

PROCEDUREOBTAIN HISTORY OF THE ACCIDENT

ASSESS TO DETERMINE THE DEGREE OF AUTONOMIC DYSFUNCTION

MAINTAIN AIRWAY, PREPARE FOR INTUBATION

ADMINISTER OXYGEN

IMMOBILIZE THE HEAD AND NECK

CHECK / MONITOR FOR VITAL SIGNS

PROVIDE IV ACCESS

PLACE ON FIRM BED UNTIL STABLE

MEASURE I/O

EXPEDITE ADMISSION OR REFERRAL

Casualty lifting