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SPINAL CORD INJURY| TYPES,
MECHANISMS, AND EMERGENCY
CARE
What is a Spinal Cord Injury (SCI)? - ANSWER-An injury that occurs when force is applied to the spinal cord, resulting in damage and various neurological deficits. What are the common causes of Spinal Cord Injury? - ANSWER-Fracture, dislocation, and subluxation (partial dislocation). What are the primary effects of a Spinal Cord Injury? - ANSWER-Loss of mobility, sensory perception, and bowel/bladder control. How is a Spinal Cord Injury classified? - ANSWER-As complete (eliminates all innervation below the injury) or incomplete (allows some function or movement below the injury). What is hyperflexion in the context of SCI mechanisms? - ANSWER-A mechanism where the head is struck against an object, causing injury. What is hyperextension in SCI mechanisms? - ANSWER-Injury caused by being struck from behind, leading to rupture of posterior ligaments. What is axial loading or vertical compression? - ANSWER-Injury caused by extreme lateral flexion of the head or landing on the head or sacrum. What is penetrating trauma in SCI? - ANSWER-Injury caused by high-speed objects like knives or bullets. What are secondary injuries in SCI? - ANSWER-Worsening of the primary injury due to factors like hemorrhage, ischemia, and neurogenic shock. What is the most common type of Spinal Cord Injury? - ANSWER-Traumatic injuries, often resulting from motor vehicle accidents, gunshot wounds, or falls. What is the average age and gender of individuals with traumatic SCIs? - ANSWER- Males, average age 43. What are the types of Spinal Cord Injury? - ANSWER-Concussion, contusion, laceration, and transection.
What is a concussion in SCI? - ANSWER-A temporary dysfunction that resolves within 24-48 hours. What is a contusion in SCI? - ANSWER-Bleeding into the spinal cord and edema. What is a laceration in SCI? - ANSWER-A tear in the spinal cord resulting in permanent injury. What is transection in SCI? - ANSWER-Complete or incomplete severing of the spinal cord, leading to loss of function below the injury. What is the goal of initial care for SCI? - ANSWER-To assess airway and respiratory needs, stabilize the spine, and prevent further injury. What are common surgical interventions for SCI? - ANSWER-Decompressive laminectomy, spinal fusion, and internal fixation. What is the purpose of a Halo Fixator? - ANSWER-To immobilize the cervical spine, typically worn for 6-12 weeks. What is the significance of monitoring vital signs post-SCI? - ANSWER-To assess for neurogenic shock and ensure adequate perfusion to the spinal cord. What are common respiratory complications following SCI? - ANSWER-Respiratory failure requiring ventilatory support and prevention of ventilator-associated pneumonia. What is spinal shock? - ANSWER-An initial response after SCI that is not circulatory in nature. What is the Glasgow Coma Scale used for in SCI assessment? - ANSWER-To evaluate level of consciousness and neurological impairment. What are the signs of neurogenic shock? - ANSWER-Bradycardia, hypotension, and hypothermia. What is the role of high-dose steroids in SCI treatment? - ANSWER-To reduce inflammation and improve outcomes after injury. What is the importance of immobilization devices in SCI? - ANSWER-To stabilize the spine and prevent further damage during transport and treatment. What are the potential complications of SCI related to the gastrointestinal system? - ANSWER-Gastroparesis and paralytic ileus, which can occur within 72 hours post- injury.
What is the role of enoxaparin in SCI management? - ANSWER-Enoxaparin is used for daily subcutaneous administration to prevent DVT. What happens to bowel and bladder function after the first few days post-SCI? - ANSWER-Bowel and bladder function may start to return as edema subsides, with variations based on the level of injury. What characterizes cervical/high thoracic spinal injuries regarding bowel and bladder function? - ANSWER-They typically result in spastic bowel and bladder function. What characterizes lower thoracic/lumbosacral spinal injuries regarding bowel and bladder function? - ANSWER-They typically result in flaccid bowel and bladder function. What is the typical duration of spinal shock? - ANSWER-Spinal shock usually lasts 24 hours but can occasionally extend to days or weeks. What physiological responses occur during spinal shock? - ANSWER-Reflexes above the injury remain intact, while reflexes below are either depressed (hyporeflexia) or absent (areflexia). What are the signs of impaired perfusion in neurogenic shock? - ANSWER-Signs include low pulse oximetry readings (less than 95%), airway distress, decreased level of consciousness, and decreased urine output. What is the significance of monitoring hourly urine output in neurogenic shock? - ANSWER-It helps assess kidney perfusion and overall fluid status, which is critical in managing the patient's condition. What are common psychosocial effects of spinal cord injury? - ANSWER-Significant behavior/emotional reactions, changes in functional ability, body image, roles, self- concept, and feelings of guilt surrounding the accident. What is the first priority in the management of spinal cord injury? - ANSWER-Airway management. What medication is commonly administered to reduce swelling in spinal cord injury patients? - ANSWER-IV steroids. What vital signs should be assessed every 2-4 hours in spinal cord injury patients? - ANSWER-ABCs (Airway, Breathing, Circulation), development of shock/complications. What SpO2 level indicates a need for further assessment in spinal cord injury patients?
What are signs of aspiration in spinal cord injury patients? - ANSWER-Stridor, garbled speech, or inability to clear airway. What is a common risk associated with spinal cord injury regarding gas exchange? - ANSWER-Impaired gas exchange and risk for aspiration. What interventions can help prevent ventilator-associated pneumonia (VAP) in spinal cord injury patients? - ANSWER-Mechanical ventilation, ABGs, pulse oximetry, kinetic bed, suction, chest physiotherapy, assisted coughing, and incentive spirometry. What is neurogenic shock and how is it monitored in spinal cord injury patients? - ANSWER-A risk for cardiovascular instability; monitored by checking blood pressure and pulse. What treatment is used for hypotension in spinal cord injury patients? - ANSWER-IV fluids, dextran, vasopressors, and atropine if heart rate is less than 60. What is orthostatic hypotension and why is it a concern in spinal cord injury patients? - ANSWER-A condition where blood vessels do not constrict quickly enough, leading to dizziness and falls when changing positions. What bladder and bowel retraining strategies may be used for spinal cord injury patients? - ANSWER-Adequate fluids, intermittent catheterization for flaccid bladder, bulk laxatives, stool softeners, and rectal suppositories. What interventions are used for managing paralytic ileus and GI bleeding in spinal cord injury patients? - ANSWER-N/G tube for decompression and ulcer prophylaxis with PPIs. What is the recommended frequency for turning and repositioning spinal cord injury patients? - ANSWER-Every 1-2 hours. What are common triggers for muscle spasms in spinal cord injury patients? - ANSWER-Cold, emotions, long-sitting, and distended bladder. What medications may be used to manage muscle spasms in spinal cord injury patients? - ANSWER-Tizanidine (Zanaflex), dantrolene, and intrathecal Baclofen (Lioresal). What is Central Cord Syndrome? - ANSWER-A common type of incomplete spinal cord injury affecting the middle portion of the spinal cord, often due to falls and hyperflexion of the neck. What are the typical symptoms of Central Cord Syndrome? - ANSWER-Leg weakness, difficulty walking, numbness, and loss of fine motor movements in arms.
