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Cervical Spine Injuries

Kinna P. Siarro, RN

and rotational shear forces exerted on the cord at the time of trauma can produce severe neurologic deficits • Edema and cord swelling contribute further to the loss of spinal cord function. .• Injuries to the cervical spine are serious because the crushing. stretching.


• Any person with a head. neck. or back injury or fractures to the upper leg bones or to the pelvis should be suspected of having a potential spinal cord injury until proved otherwise .

.• Provide immediate immobilization of the spine while performing assessment. • Breathing. • Airway. • Intercostal paralysis with diaphragmatic breathing indicates cervical spinal cord injury.

.• In conscious patient. • Disability—assess neurologic status. observe for increased respiratory rate and difficulty in speaking due to shortness of breath. • Circulation.


it may be done nasally. • Open the airway using the jaw-thrust technique without head tilt. • If the patient needs to be intubated.• Immobilize the cervical spine. .

• If respirations are shallow. • Administer high-flow oxygen to minimize potential hypoxic spinal cord damage. assist with a bag-valve mask. .


this may indicate the type of injury incurred. .• Assess the position of the patient when found. • Neck and back pain/extremity pain or burning sensation to the skin. • History of unconsciousness. • Hypotension and bradycardia accompanied by warm. dry skin— suggests spinal shock.

• Loss of bowel and bladder control.• Total sensory loss and motor paralysis below level of injury. • Loss of sweating and vasomotor tone below level of cord lesion. . usually urinary retention and bladder distention. • Priapism—persistent erection of penis.

.• Hypothermia—due to the inability to constrict peripheral blood vessels and conserve body heat. • Loss of rectal tone.


NURSING ALERT • A spinal cord injury can be made worse during the acute phase of injury. • Proper handling is an immediate priority. . resulting in permanent neurologic damage.

• Insert an NG tube.V. • Keep the patient warm. access. . • Continue with repeated neurologic examinations to determine if there is deterioration of the spinal cord injury. and bradycardia. • Initiate I. • Insert an indwelling urinary catheter to avoid bladder distention. hypothermia. • Monitor for hypotension.

. loading dose over 15 minutes. • Continue the infusion for 23 hours. followed by a 5. • Pharmacologic interventions: high-dose steroids (methylprednisolone). • The standard regimen is 30 mg/kg I.V.4 mg/kg/hour infusion to be initiated 45 minutes later.• Be prepared to manage seizures.