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Spinal Cord Injury: Cedric Muceros BSN 3C
Spinal Cord Injury: Cedric Muceros BSN 3C
o What is SCI?
A spinal cord injury — damage to any part of the spinal cord or nerves at the end of
the spinal canal (cauda equina) — often causes permanent changes in strength, sensation and
other body functions below the site of the injury.
Sports and recreation injuries. Athletic activities, such as impact sports and diving in shallow
water, cause about 10% of spinal cord injuries.
Alcohol. Alcohol use is a factor in about 1 out of every 4 spinal cord injuries.
Diseases. Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal
cord injuries.
RISK FACTORS
o CAUSES
The most common cause of spinal cord injury is trauma. Nearly half of the injuries are caused by
motor vehicle accidents. Other types of trauma include: falls from heights, violence (stabbing or
gunshot wounds to the spine), and sporting injuries (diving, football, rugby, equestrian, etc.).
Spinal cord injury can also be caused by compression of the cord by a tumor, infection, or
inflammation. Some patients have a smaller than normal spinal canal (called spinal stenosis) and
are at a higher risk of injury to the spinal cord. All tissues in your body including the spinal cord
require a good blood supply to deliver oxygen and other nutrients. Failure of this blood supply to
CEDRIC MUCEROS BSN 3C
the spinal cord can cause spinal cord injury. This can be caused by an aneurysm (ballooning of a
blood vessel), compression of a blood vessel or a prolonged drop in blood pressure.
o TYPES OF SCI
Complete: A complete injury causes total paralysis (loss of function) below the level of the
injury. It affects both sides of the body. A complete injury may cause paralysis of all four limbs
(quadriplegia) or the lower half of the body (paraplegia).
Incomplete: After an incomplete injury, some function remains on one or both sides of the body.
The body and brain can still communicate along certain pathways.
o DIAGNOSTIC EXAMS
o CLINICAL MANIFESTATIONS
Loss of movement
Loss or altered sensation, including the ability to feel heat, cold and touch
Loss of bowel or bladder control
Exaggerated reflex activities or spasms
Changes in sexual function, sexual sensitivity and fertility
Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
Difficulty breathing, coughing or clearing secretions from your lungs
o EMERGENCY MANAGEMENT
Urgent medical attention is critical to minimize the effects of any head or neck trauma.
Therefore, treatment for a spinal cord injury often begins at the scene of the accident.
Emergency personnel typically immobilize the spine as gently and quickly as possible using a
rigid neck collar and a rigid carrying board, which they'll use to transport you to the hospital.
CEDRIC MUCEROS BSN 3C
o MEDICAL MANAGEMENT
Intravenous (IV) methylprednisolone (Solu-Medrol) has been used as a treatment option for an
acute spinal cord injury in the past. But recent research has shown that the potential side effects,
such as blood clots and pneumonia, from using this medication outweigh the benefits. Because of
this, methylprednisolone is no longer recommended for routine use after a spinal cord injury.
o SURGICAL MANAGEMENT
Often surgery is necessary to remove fragments of bones, foreign objects, herniated disks or
fractured vertebrae that appear to be compressing the spine. Surgery may also be needed to
stabilize the spine to prevent future pain or deformity.
o NURSING INTERVENTIONS
Immobilize the entire spine of any patient with known or potential SCI
Immobilize neck with a hard collar. See guideline for cervical spine assessment
Use log roll with adequate personnel to turn patient while maintaining spine alignment
For children < 8 years of age use an airway pad to promote neutral cervical spine
position
Remove from spinal board on arrival in ED or as soon as resuscitation allows
Maintain neck in neutral position by use of a hard collar, but change to two-piece collar
for comfort and avoidance of complications (e.g. pressure area, venous obstruction,
aspiration) within 6 hours of admission.
o COMPLICATIONS
May cause circulatory problems ranging from low blood pressure when you rise (orthostatic
hypotension) to swelling of your extremities. These circulation changes may also increase your
risk of developing blood clots, such as deep vein thrombosis or a pulmonary embolus.
CEDRIC MUCEROS BSN 3C