Spinal Injuries Flashcards
What is the diagnostic pattern for SCI?
The diagnostic pattern for SCI involves:
1. mechanism of injury
2. pain / tenderness over or adjacent to the spinal vertebra
3. impaired motor or sensory function
4. impaired autonomic function
What is neurogenic shock?
Interruption to normal sympathetic nervous system function by high spinal cord or direct CNS injury can result in loss of vasomotor tone, resultant hypotension and in certain instances bradycardia.
Particularly true of injuries above the site of sympathetic spinal outflow (above T5).
What is spinal shock?
Spinal shock refers to a transient condition following acute cord injury which is characterised by flaccid paralysis below the site of the lesion, areflexia and anaesthesia.
Spinal shock will often resolve over the month following the initial injury & spinal reflexes will in most instances return.
What are the clinical features of a spinal cord injury?
- Impaired motor function
- diaphragmatic ventilation
- paralysis
- flaccidity
- abnormal posturing - Impaired sensory function
- local or generalised paresthesia
- loss of proprioception - Impaired autonomic function
- hypotension
- bradycardia
- thermoderegulation
- priapism
What is the NEXUS criteria?
A study which indicated that radiography is required for patients unless they meet ALL of the following criteria:
1. No posterior midline cervical-spine tenderness
2. No evidence of intoxication
3. Normal level of alertness
4. No focal neurological deficit (sensory or motor)
5. No painful distracting injuries
What is the standard management for a patient with a suspected spinal cord injury?
Are any of the NEXUS criteria present?
If yes, apply mandatory spinal motion restriction.
Hypotensive & bradycardic?
YES:
Consider neurogenic shock:
- FAST
- IV fluids
- inotropic support
- analgesia
- antiemetic
NO:
Hypotensive & tachycardic?
YES:
- FAST
- IV fluids
- analgesia
- antiemetic
NO:
Consider analgesia & antiemetic
