Concept Table Spinal Cord Injury
Concept Table Spinal Cord Injury
What do I already know about this disease New Concepts/ Key considerations for this disease process:
process?
Basic Typically caused by trauma to the Caused by trauma or damage to the spinal cord
Pathophysiology: head/neck/back Temporary or permanent alteration in spinal cord function
Can be crush, whiplash, Caused by MVAs, falls, violence, and sports injuries most
penetrating, or due to edema commonly
May result in varying degrees of May lead to secondary conditions such as neurogenic shock
disability Flexion, hyperextension, compression, and flexion rotation injuries
Risk Factors: High risk behaviors Risk factors include those populations that may typically engage in
Osteoporosis high risk behaviors such as adolescents, young adults, or males
Previous spinal cord injury People with osteoporosis or other previous spinal injuries are at
Head trauma risk as they have less protection for their spinal cord in the event
Significant mechanism of injury of an injury
Health Avoid risky behaviors Identify high risk people and provide education on injury
Promotion/ Seek medical attention prevention
Education: immediately after an injury to the Use seatbelts, car seats, and avoid distracted or impaired driving
head/neck/back or with significant
mechanism
Use equipment with spinal
protection when playing sports
such as football
Signs and Difficulty breathing Motor and sensory impairments
Symptoms No gag reflex Impaired respiration and cough
(Assessment cues Paralysis Bradycardia
the problem/ Pain below level of injury Hypotension
disease process is Sensory changes Vasodilation
occurring): Autonomic Dysreflexia Neurogenic bladder
Decreased GI motility and paralytic ileus
Neurogenic bowel
Impaired thermoregulation
Initial Treatment Protect the airway Maintaining and supporting the airway
(Nursing Prevent movement or additional Prevent secondary damage
interventions and injury to the spine Sedation
Collaborative Place a cervical collar and splint Stabilization and decompression of the spine
Care to include spine while supine on bed Surgical treatment to stabilize spine
medications): Steroids to reduce/prevent swelling Methylprednisolone
Antibiotics for open injuries Heparin
Special Nursing May require long periods of PT/OT May require extensive external splinting for long periods of time
Considerations/ to regain some function Patients will likely need assistance with ADLs
Patient advocacy: Permanent disability is common All SNS functions will be impaired with a high thoracic or cervical
spine injury
I want to learn more about emergency use of steroids for spinal cord injuries. Currently, the results are mixed on the use of
methylprednisolone to reduce spinal swelling. I wonder if a different steroid or another anti-inflammatory agent would prevent
further harm.