Spinal cord injury Flashcards
What does the spinal injury disrupt?
Spinal cord or blood supply
What are the degrees of spinal injury?
Complete
Incomplete
Complete spinal injury
Total loss of sensory and motor function; nothing in tact
Incomplete spinal cord injury
Varying degrees of loss of function bc some of it is intact
Main causes of spinal cord injuries
MVA
Falls
Violence
Sports
Main risk factor for spinal cord injury
Young male
drugs and alcohol
List of injury mechanisms that lead to spinal cord injury
Hyperflexion
Hyperextension
Axial loading
Rotation
Penetration
What are the different types of damage that can occur to a spinal cord?
Concussion
Contusion
Laceration
Transection
What does a contusion of the spinal cord lead to?
Edema
Possible neuronal death
What is a spinal cord laceration?
Cord tear that is permanent
What is a spinal cord transection?
Cord is severed leaving no function below the severed spot
What causes the secondary injury of a spinal cord injury?
Cellular damage
Vascular changes
Decreased blood flow
What do we want to avoid with a spinal cord injury?
Secondary injury
Neurogenic shock
What needs to be included in the assessment for a _spinal cord injur_y?
Airway, breathing, circulation
What do you need to do before assessing your patient with a spinal cord injury?
Make sure they are immobilized
- bed rest, log roll, midline
- keep them suckers still!
What can interfere with an accurate assessment of a spinal cord injury and give false results?
Spinal shock
What is spinal shock?
Temporary suppression of reflexes
What can cause hemorrhage and blood vessel damage in a spinal cord injury?
The edema - too much fluid causes a bulge and hemorrhage. It also can damage the vessels
How often do we assessments for a spinal cord injury?
q4hours minimum
Top 5 nursing priorities when managing a spinal cord injury
Immobilize
Airway management
Respiratory needs
Hemodynamic support
Neuro protection
During intubation of a patient with a spinal cord injury, what do you do?
You keep the patient immbolized and still
You have a high level spinal cord injury. What type of airway management do you anticipate?
Tracheostomy
Patient has an injury @ C2. What does this mean for the patient and for you?
Means patient has impaired diaphragmatic innervation - so watch for aspiration risk since this means they can’t cough.
What types of interventions will you be doing to support hemodynamics of a spinal cord injury?
Keep oxygenated
Fluids
Rule out shock and be monitoring for neurogenic shock (since this is an injury to spinal region)
How do we provide neuroprotection to spinal cord injury patients?
Methprednisone steroid
What is the concern when using Methprednisone steroid?
Blood sugar will rise
What can we give to counteract the high BS with Methprednisone steroid?
Glucose control with insulin
Prophylactic protonix and prilosec for GI ulcers
