Spinal Cord Injury
Spinal Cord Injury
Shannon G. Johnston, RN, CEN
Liberty University
Abstract
There are many types of spinal cord injuries (SCI). Patients with SCI can symptoms that range from mild neurologic impairment (such as numbness and tingling of extremities or neck pain) to devastating total body paralysis depending on the extent of damage and where in the spinal cord the damage occurs. Management of airway, breathing and circulation are key with SCI patients, as well as immediate immobilization. With proper care and intervention, chances of survival are greatly improved.
Spinal Cord Injury
Spinal cord injuries (SCIs) most commonly occur as a result of falls, motor vehicle accidents, violence, sports …show more content…
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Quick but thorough evaluation, diagnostic testing and treatment determined by findings is essential to sustain life in most patients with SCI. Airway, breathing and circulation must first be assessed followed promptly by full spinal immobilization including a cervical collar and long backboard. Immobilization can help decrease the chance of secondary injury (Nayduch, 2010). Continuous monitoring of blood pressure and temperature regulation must also occur. Nurses can also conduct a thorough neurologic exam which must be reassessed often to monitor for a change or worsening in condition. Movement including flexion and extension of body parts, pupil exam, muscle tone and vital signs must all be assessed to determine the extent of injury.
Diagnostic evaluation leading to diagnosis includes physical exam, CT scan, MRI, radiologic studies and myelogram (Heuther, 2008). Treatment is aimed at reducing initial injury and preventing secondary damage. The patient must be closely monitored for spinal shock and automonic hyperreflexia. Patient education is a necessary nursing intervention for patients with SCI.
All spinal cord injuries require close monitoring and therefore should be in an intensive care setting. Early stabilization (either in the field or in the ED) is key in treating SCI, and must continue on through the patient’s admission to the ICU and thereafter. Surgery to repair boney injury, decompress nerves and tissue, or insert long-term