Spinal Cord Injuries Handout Flashcards
In the E.D, what is given immediately to SCI patients
High doses of steroids are given but they must be given within 8 hrs to be effective
What is diagnosis of a SCI
CT
MRI
ALWAYS ASSESS FOR SECONDARY INJURIES
What assessment is crucial in a SCI
Respiratory
The pt will have decreased ventilation , decreased vital capacity tidal volume, and ineffective cough, intubation may be necessary
What are early signs of a SCI that must be reported immediately
Decrease in motor strength
Decrease in sensation
Bowel and or bladder dysfunction
What is neuropathic pain described as
Pain that is constantly aching, burning… Can develop into chronic neuropathic pain
What is neuropathic pain treated with
Anti seizure meds
TCAs
Steroid injections into the spine
Local anesthetics
Poikilothermism
The inability to adjust to changes in environmental temperature
Often develops following injury
Porprioception
Sense of the position of objects in relation to the body
Physiologically, injury to the spinal cord results in what
Inflammatory response Bleeding from the capillaries Cord edema Decreased cord oxygenation Destruction of neurons begins in minutes and within 24 HR nerve function can be lost
When is autonomic dysreflexia is caused by what level of SCI
SCI above T6
What is autonomic dysreflexia
Caused by irritation to specific nerves of the autonomic nervous system located in the ,owner abdomen and triggered by distention of the bladder, distended or impacted rectum, severe scrotal edema, severe pressure ulcers
What are symptoms of autonomic dysreflexia
Sudden pounding headache
Perfuse Diaphoresis
Facial flushing, nausea, shivering, blotchy skin,anxiety,
If a patient is high risk for DVT, what will be anticipated
Inferior vena cava filter
What are complications of SCI
Autonomic dysreflexia DVT wound infection Orthostatic hypotension Cardiac arrthymias Constipation Ileus Respiratory failure
WHAT HAPPENS WITH A SCI IN THE C2-C3 AREA
It may be fatal
What happens with a SCI in the C4 and above area
Usually requires permanent mechanical ventilation
What occurs with SCI in the C3-C5 region
Pt may be able to move there head, shrug shoulders
What does a SCI in the area of C6 indicate
Usually preservation of the shoulder, elbow, wrist
May have gross arm movements
May be able to use thumbs
What occurs with SCI of C7-C8
May be able to roll over
Sit up
Use fingers
Flex elbows
Injuries T6 and above are at risk for what
Autonomic dysreflexia
SCI at L2 and below pose what kinds of injuries
Dysfunction of the bowel and bladder, hips, knees, ankles, amd sexual dysfunction, will have arm movement but no leg movement
What are all SCI patients at risk of
Joint contractures
Muscle atrophy
Muscle spasticity
( occurs within 6 months)
What is spasticity treated with
Baclofen ( Lioresal)
Implantable med pumps
Flexeril
Valium
