You are on page 1of 18

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.

PRIMARY ASSESSMENT .

• 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.

PRIMARY INTERVENTIONS .

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. .

SUBSEQUENT ASSESSMENT .

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.

GENERAL INTERVENTIONS .

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.