Computerised Asia scoring for SCI- Nursing role

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  • .Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis.
  • This form is used to do ASIA scoring-its divided into sensory and motor scoring chart.The sensory levels are scored on a 0- 2 scale bases for each dermatome on both right and left side.Each dermatome is tested for light touch and pinprick sensation and labeled as NT( not testable) if cannot be tested.0- given if the sensation is absent1- if the sensation is present but impaired2- if the sensation is normal
  • Motor scoring chart – here the reflexes are checked and scoring is given on a 0 to 5 scale basis.0- is given for total paralysis1- for palpable and visible contraction2-active movements, full range of motion gravity eliminated3-active movements, full range of motion against gravity 4- active movements, full range of motion against gravity and provides some resistance5- active movements, full range of motion against gravity and provides normal resistanceNT- not testable
  • This helps in classifying the patients into 5 groups.
  • ( below the neurological level of injury )
  • Less than ½ of the key muscles below the neurological level have a grade 3 or less.
  • At least ½ of the key muscles below the neurological level have a grade 3 or better.
  • Computerised Asia scoring for SCI- Nursing role

    1. 1. Sumi Sunny Research Staff Nurse Guide:-Dr Deepak Agrawal Addl. Professor Department of Neurosurgery JPNATC AIIMS
    2. 2.  A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease  The American Spinal Injury Association (ASIA) is widely used to document sensory and motor impairments following SCI  It is based on neurological responses, touch and pinprick sensations tested in each dermatome
    3. 3.  To document sensory and motor impairments following SCI.  To categorise the patients and give appropriate care.  To assess nursing role in using ASIA score in SCI
    4. 4. 1. MOTOR SCORING 2. SENSORY SCORING
    5. 5.  C5 – Elbow flexors  C6 – Wrist extensors  C7 – Elbow extension  C8 – Finger flexors  T1 – 5th digit abduction  L2 – Hip flexion  L3 – Knee extension  L4 – Ankle dorsiflexion  L5 – Long toe extension  S1 – Ankle plantar flexion
    6. 6. 1. ASIA-A 2. ASIA-B 3. ASIA-C 4. ASIA-D 5. ASIA-E
    7. 7.  Complete SCI  No motor or sensory function is preserved Nursing Implication: ◦ To prognosticate the patient ◦ Appropriate care should be provided to reduce high risk of bed sore
    8. 8.  Incomplete SCI  Sensation : Present  Motor function: Absent  Nursing Implication: ◦ As sensation is low care should be provided to prevent bed sore
    9. 9.  Incomplete SCI  Sensation: Present (complete)  Motor: Present but grade 3 or less.  Nursing Implication: ◦ Nurse motivates patient and their relatives
    10. 10.  Incomplete SCI  Sensory: Present (complete)  Motor: Present but have a grade more than3.  Nursing Implication: ◦ Motivate the patient for physiotherapy and rehabilitation.
    11. 11.  Incomplete SCI  Motor and sensory functions are normal  It implies the presence of a spinal cord injury but without detectable neurological deficits.
    12. 12. TOTAL CASES ADMISSI ONS OPERAT ED DEATH (%) NON- OPERAT ED DEATH (%) CERVICAL SPINE INJURY 289 178 115 5.6% 174 4.6% DORSAL SPINE INJURY 112 69 46 - 66 1.7% LUMBAR SPINE INJURY 119 60 30 - 89 1.7%
    13. 13. TOTAL CASES COMPLETE INCOMPLETE DEATH (%) CERVICAL SI 289 116 173 5.9% DORSAL 112 31 81 0.89% LUMBAR 119 19 100 0.89%
    14. 14.  Manual system of calculating score is: ◦ Cumbersome ◦ Time consuming  Computerized system was developed: ◦ For easy assessment and entry of motor and sensory powers for automatic calculation of ASIA Score Need of this system
    15. 15.  Nurses can play a vital role in accurate assessment of ASIA score using computerized software.  This will help in research and follow up of SCI patients.  Document sensory and motor impairments following SCI.  Helps to prognosticate the patient.  Categories the patients and give appropriate care.

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