Spinal Cord Injury and Treatment

Question 1

A brain injury can be either a primary or secondary injury

Answer 1

Primary; Injury to the brain and its associated structures that occurs immediately upon contact to the head

Secondary; The after effects of a head injury, and can onset from minutes to days later

Question 2

How to do a focused secondary assessment on a head/neck injury patient

Answer 2

1) Use a full body assessment
2) Emphasis should be placed on the head and face, by checking the integrity of the skull, looking for any fluids draining from the eras or behind the ears
3) Asess pupils and reactivity
4) Assume they have spinal damage and c-spine issues
5) Glascow Coma Scale

Question 3

Vital sign reactions to spinal or head injuries

Answer 3

• Hypertension
• Bradycardia
• Irregular respirations

These three things are called Cushing’s Triad, and indicate significant cerebral edema and increased intracranial pressure.

Question 4

General management of head injuries (listed in priority order)

Answer 4

1) Establish and maintain an airway, including inserting an OPA if there is no gag reflex. DO NOT insert an NPA into a patient with brain trauma.
2) High flow oxygen
3) Control bleeding, but do not apply direct pressure
4) Closely monitor LOC
5) Anticpate vommiting so you can prevent aspirations
6) Be prepared for seizures or rapid change in conditions

Question 5

General management of spinal injuries (listed in priority order)

Answer 5

1) C-Spine
2) Open and maintain a patent airway using jaw thrust (not head-tilt chin lift)
3) Hold head in neutral, in-line position
4) Insert OPA if no gag reflex
5) Have a suction unit ready
6) Provide high flow oxygen
7) Continously monitor airway