Spinal Cord Injury Candida I. Marin Keiser University Nursing Karen Osbeck July 20, 2011

paralysis/ paresis of all four extremities and truck. For example injuries in the cervical region results in quadriplegia. It is important that the nurse be knowledgeable about the features of spinal injuries and the steps in evaluating and implementing care. potentially resulting in death or a crippling permanent disability. alcohol and acts of violence (gun shot and knife wound) account for a large amount of traumatic spinal cord injuries. motor vehicle accident or gunshot wounds. reflexes and control of elimination. High risk activities. either temporary or permanent. such as sport accidents/ injuries. injuries below T-1 results in paraplegia-paralysis/paresis of the lower extremities. Not all spinal cord injuries are created equal. Breathing is assessed by looking. and can be very devastating to the patient and family. Head/ neck injuries deserve special attention for their potential to affect the spinal cord. Most spinal cord injuries are caused by trauma. sensory function. The article make reference that a suspected spine injury not be moved without immobilization unless absolutely necessary to maintain the ABCs.2 SPINAL CORD INJURY Spinal cord injuries (SCIs) entail the loss of motor function. Well organized initial care and identification of conditions that require immediate attention must be given top priority. listening . The International Standards for Neurological and Functional Classification of Spinal Cord Injury is a widely accepted system describing the level and extent of injury based on a systematic motor and sensory examination of neurologic function (American Spinal Injury Association 2001). Yet. so the nurse must be astute to the exact location of injury. The prospect of catastrophic neurological injury as a result of damage is a very real possibility. Spinal cord injury (SCI) is damage to the spinal cord resulting in a change.

If the patient is not able to move below a certain point. or tests the doctor orders. capability to follow instructions and eye opening. The nurse must control the patient’s position because the patient may have lost consciousness and while awakening. routinely will attempt to move. The nurse must remain calm and in control to better assistant the patient with critical care. they have common characteristics in the clinical presentation of these injuries. it's also . A spinal cord injury can be a very critical condition that commands around-the-clock care for the patient (DeWitt 2001). Nursing Implications is to assess consciousness by evaluating orientation. The patient will most likely be admitted to the hospital to stay for weeks.3 SPINAL CORD INJURY for respirations. The article made reference to sport injuries in athletes but this model could be used for any spinal injury. it's your responsibility not only to make sure the patient is receiving any treatments. The most important action will be to provide the patient with oxygen. The patient’s behavior can be scored formally with the Glasgow coma scale. suction as needed. he may be at risk for certain complications. As a nurse. Injuries to the cervical spine and the head often occur together and even when both are not present in a patient. When regaining consciousness. intubation and mechanical ventilation may also be necessary. injury at or above these levels can result in paralysis of the diaphragm (Clifford 2009). An injury at C4 or above poses a great risk for impaired spontaneous ventilation because of the involvement of the phrenic nerve. C5. which correlates with prognosis for brain injuries. evaluation of subjective and objective assessment can take place. the patient may be restless and may need additional support to sustain spine precaution (Ditunno 2005). medications. After the stabilization of the patient within the ABCs framework.

This will allow for better communication with the patient. The nurse should ensure they are communicating effectively with the patient. so that they should fully understand what is going on with him or her physically. The complexity of a spinal cord injury requires the nurse to pay close attention to every detail the patient tells you about or that you observe. . support them and praise them. Be honest and upfront with him/her. as immobilization drastically increases the risk pulmonary embolism. pay attention to the patient. that he or she is taken care of mentally and emotionally as well (Sparks 2001). The nurse will need to keep watching the patient’s cardiovascular and respiratory health.4 SPINAL CORD INJURY your job to see that the patient is comfortable. they should study and research the patient type/cause of injury. The patient should be given current and correct information and treatment education. so that you can report any problems or complications quickly. as this will improve their emotional well-being as a whole and could stimulate them to keep going and not to give up. As they progress and starts gaining capability to do certain things on their own. transfer and medication regimen). don't sugarcoat any aspect because this could lead to mistrust later on. this includes what the patient and family members will need to be taught pertaining to all aspects of the patient care (ADL’s. Most notably. They just require a listening ear at some point. especially watching for blood clots.

Springhouse Corporation.. The international standards booklet for neurological and functional classification of spinal cord injury. Donovan WH. Chicago.. Everett. Nursing Diagnosis Reference Manual. revised ed. The Journal of Musculoskeletal Medicine. Thomas L. Young W. Ill: American Spinal Injury Association... American Spinal Injury Association. Cesarz. Feb 2005. Taylor. Sparks M Sheila. Paraplegia. Ditunno JF Jr. Februarys 2009 I .32(2):70-80. MD. 2000:1-23.B. MPH. 2001.5 SPINAL CORD INJURY Reference American Spinal Injury Association. DeWitt Susan C. W. MD. Gaurav Kapur. International Standards for Neurological Classifications of Spinal Cord Injury. June 2001. Clifford R. et al. Saunders Fundamental Concepts and Skills for Nursing. MD Diagnosis and management of cervical spine injuries in athletes. & Cynthia M.


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