SPINAL CORD INJURY o Place the head in a neutral position

o If there is resistance, stabilize the neck in

COMMON CAUSE: the position in which you found it.
 Car accident 2. Establish and maintain airway and provide
 Motorcycle accidents adequate ventilation.
o Perform CPR if necessary, but do not
 Fall
move the patient.
 Diving
Radial BP - 80mmHg
 Contact sports such as horseback riding, football,
Femoral - 70 mmHg
skiing
Carotid - 60 mmHg
3. Movement of patient
o Move the body of the patient as one
unit.
o Immobilize victim before moving.
o Put the spinal cord in a straight
position.

SUBMERSION INJURIES (Drowning)

 Most victims are children 5 years old below.
 3,000 Filipinos die every year.

RISK FACTORS
 Inability to swim
 Use of alcohol or drugs
 Trauma
SIGNS AND SYMPTOMS  Seizures
 Pain is localized and severe  Hypothermia
 Pain when moving injured neck shoulder or leg  Stroke
 Soft tissue injury associated with trauma  Child neglect
 Numbness (first thing that the patient will feel)
weakness, or tingling in the arms or legs
 Hemiparesis (one side weakness) hemiplegia ★ Before saving somebody make sure that you are
(one side of body is paralyzed) - MOST safe first.
RELIABLE SIGN OF SCI
 because of the decussation of the pyramidal tracts
: R Spatial perception (interpretation of what you TYPES OF DROWNING
can see) L Speech Active Drowning
 Urinary and fecal incontinence (sacral 1-5 injury)  If you cannot reach the person throw
- they cannot control the urinary and fecal something he/she can grab on
 Impaired breathing - no chest movement only o Rope
slight abdominal movement. (Cervical 1-7 injury) o A float device
Cervical 3-4 is where phrenic nerve is who o Styrofoam
controls the diaphragm o Cars spare tire
Passive Drowning - for the near drowning the
victim is not breathing and face down in the
Thoracic is 12 water.
PROGNOSIS: Is best when victims submerged in
FIRST AID water for less than 5 minutes and when CPR is
1. Establish and maintain in line stabilization. (If started within 10 minutes of submersion.
you don't know how to touch patient, do not touch
it.)
HYPERTONIC (SALT WATER) - draws water the
protein rich fluid from the vascular space to the alveoli.
 This causes impaired alveolar ventilation and
resultant intrapulmonary shunting which
compound the HYPOXIC STATE.
 Can lead to acute respiratory distress syndrome

HYPOTONIC (FRESHWATER) - is rapidly absorbed

into the circulatory system through the alveoli.
 Can lead to pulmonary edema
FRESH WATER - is often contaminated with chlorine
and mud
 this causes breakdown
 Impairing alveolar and ventilation and resulting
in HYPOXIA
 The body attempts to compensate for the loss of
oxygen by shunting blood to the lungs this result
in increased pulmonary pressure and further
deteriorate the respiratory system.

INITIAL TREATMENT:
 Turn patient who are face down in the water face
up.
 Support the neck and head with one hand and
place other hand on the front of the patient to keep
the head and neck stabilized and then turn.
 Keep the patient in a neutral position and
stabilized the
o Stabilize the patients head and neck
o Treat a patient who is unconscious into
the water as if a SPINAL CORD
INJURY were present.
 SUPPORT the patient by a backboard, if no rigid
device is available.
 Keep body straight and protect the spinal cord.
 Then perform CPR WITIHN 10 minutes of
submersion in the water.

COLLABORATIVE CARE
 Rewarming when hypothermia is present
 Mechanical ventilator
 MANNITOL (potent diuretic) - for increase ICP
and increase IOP
 FUROSEMIDE (loop diuretic) - for ascites,
pulmonary edema, pitting edema