SCI Interprofessional Care

Question 1

Pin site care

Answer 1

Potential for infection at sites of tongs or halo pin insertion
Preventative care based on hospital protocol
Common protocol: cleansing with ½ strength peroxide and NSS 2x daily + abx ointment
Always have a wrench at bedside to unscrew and start chest compressions

Question 2

Drug Therapy

Answer 2

Low molecular weight heparin (enoxaparin)

Prevent VTE

Question 3

Vasopressor agents

Answer 3

Phenylephrine; norepinephrine
MAP > 85-90 mmHg
Significant risk of complications
Finger, toe capillaries may constrict to point of ischemia

Question 4

Autonomic Dysreflexia

Answer 4

Massive uncompensated CV reaction mediated by SNS
-SNS responds to stimulation of sensory receptors – parasympathetic nervous system unable to counteract these responses.
HTN and bradycardia
Most common precipitating factor is distended bladder or rectum

Question 5

Manifestations of Autonomic Dysreflexia

Answer 5

HTN up to 300 mmHg systolic
Throbbing headache
Marked diaphoresis above level of injury
Bradycardia (30-40 bpm): parasym tries to respond but can only drop HR
Piloerection
Flushing of skin above level of injury
Blurred vision or spots in visual field
Nasal congestion
Anxiety
Nausea

Question 6

Intramedullary Tumor

Answer 6

within the spinal cord

Question 7

Intradural extramedullary

Answer 7

between the spinal cord and dura

Question 8

Extradural

Answer 8

outside the dura