MED/SURG: TRAUMA: INITIAL MANAGEMENT/NECK & SPINAL CORD INJURY

Question 1

1. Airway…?
2. Breathing:

• C3 & above?
• C4-5 ?

Circulation: Monitor for this type of shock?

Answer 1

Airway immobilization

C3 and above = apnea

C4-5 NEED VENTILATOR

Neurogenic Shock

Question 2

Neurgenic Shock

Answer 2

–Circulation
•Neurogenic Shock –immediately after injury. Loss of vasomotor tone & pooling of blood in periphery; unopposed PSN; Disruption in pathways between LMN & UMN
–Flaccid paralysis
–Loss of reflex activity
–Bradycardia
–Hypotension
–Paralytic ileus

Question 3

ER Care and Patient Goals

1. ABC
2. STABILIZE (4)
3. PREVENT(1)

Answer 3

1. ABC
2. Stabilize SCI
3. SBP>90-100
4. HR 60-100
5. UO > 30 ml/hr

PREVENT HYPOTHERMIA

Question 4

LAB WORKUP

Question 5

RADIOLOGICAL EVALUATION

Question 6

RADIOLOGY REVIEW

• MRI
• CT SCANE

Answer 6

• MRI soft tissue
• CT Scan bone

Question 7

SCI & SHOCK

Neurogenic Shock occus only in the presence of acute SCI above ___?___

Answer 7

ABOVE T6

Question 8

Hypotension and/or shock with acute SCI at or below T6 is caused by ___?___

Answer 8

HEMORRHAGE

Question 9

NEUROGENIC SHOCK IS CAUSED BY?