Acute Spinal Cord Injury Flashcards
What are the ABCs of a spinal cord injury?
Airway
Breathing
Circulation
What is spinal shock?
Worse neurological damage than in reality for a brief period after injury
Why are high doses of methylprednisolone used in SCI?
Inhibit inflammation (within first 8 hours)
What do you want to do with BP in SCI patients?
Keep it up
What should be done post SCI immediately?
Stabilize the spine and management of fractures
What is used for fracture management?
Traction of C spine (halo and tongs)
Positioning
Orthoses
Surgery
When should surgery be considered after a SCI?
When fracture is unstable
Malalignment
Continued cord compression
Worsening Neuro status
What is an advantage of early surgery after SCI?
Get mobility sooner (within 72 hours)
What is an advantage of late surgery after SCI?
More medically stable
What are complication with anterior surgery approach post SCI?
Effects swallowing, respiration, and speech
What are complication with posterior surgery approach post SCI?
Cannot do any lifting, pushing, or pulling with arms due to cutting through scapula
What are the implications of fusion surgery?
Loss of ROM and function
What is lost in SCI?
Muscle pump to aid with venous return
Orthostatic hypotension
Drop in BP > 20 mmHg systolic and > 10 mmHg diastolic within 3 minutes of supine to upright
What are causes of Orthostatic hypotension?
Decreased vasoconstriction
Decreased venous return
Dehydration
What are presentations of Orthostatic hypotension?
Pale, sweating, dizziness, nausea, lightheaded, blurry vision, and shortness of breath
What is used to manage Orthostatic hypotension?
Abdominal binder
Meds
Initial mobilization
Tilt table
Hydration
What are musculoskeletal complications that happen with SCI?
Osteoporosis
Hetertopic ossification
Spasms/spasticity
How can you treat osteoporosis?
Ambulation, prolonged standing, and e stim
What is hetertopic ossification?
Abnormal bone growth as a result of immobility
What is treatment of hetertopic ossification?
ROM, NSAIDs, and surgery
Why is positioning important post SCI?
Prevent skin breakdown
Improve breathing
Improve flexibility and prevent contractures
Normalize BP
Manage spasticity
Why would you want someone with a SCI to have mild tightness of back extensors?
Helps with transfers
Why would you want someone with a SCI to have excessive extension and ER of shoulders?
Helps with transfers
Why would you want someone with a SCI to have tight long finger flexors?
To help them grip when they can’t control hands
