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Sci Presentation

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  • 1. Spinal Cord<br /> injury<br />
  • 2. S C I<br />&gt; is damage or trauma to the spinal cord that results in a loss or impaired function causing reduced mobility or feeling and resulting in a change, either temporary or permanent, in its normal motor, sensory, or autonomic function..<br />
  • 3. Most Common Causes<br />Motor Vehicle Accidents<br />Violence<br />Falls<br />Sports Injuries<br />
  • 4. Pathophysiology<br />Damages to the Spinal Cord ranges from: <br />Transection of Cord<br />
  • 5.
  • 6. The vertebral column provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs. The vertebral disks serve as shock absorbers during activities such as walking, running, and jumping. They also allow the spine to flex and extend.<br />
  • 7. Clinical Manifestations<br /><ul><li> Incomplete Spinal Cord Lesion
  • 8. Complete Spinal Cord Lesion</li></li></ul><li><ul><li> Incomplete Spinal Cord Lesion</li></ul>Anterior Cord Syndrome<br />- is when the damage is towards the front of the spinal cord, this can leave a person with the loss or impaired ability to sense pain, temperature and touch sensations below their level of injury. Pressure and joint sensation may be preserved. It is possible for some people with this injury to later recover some movement.<br />Central Cord Syndrome<br />- is when the damage is in the centre of the spinal cord. This typically results in the loss of function in the arms, but some leg movement may be preserved. There may also be some control over the bowel and bladder preserved. It is possible for some recovery from this type of injury, usually starting in the legs, gradually progressing upwards<br />Brown-Sequard Syndrome<br />- is when damage is towards one side of the spinal cord. This results in impaired or loss of movement to the injured side, but pain and temperature sensation may be preserved. The opposite side of injury will have normal movement, but pain and temperature sensation will be impaired or lost.<br />Posterior Cord Syndrome<br />- is when the damage is towards the back of the spinal cord. This type of injury may leave the person with good muscle power, pain and temperature sensation, however they may experience difficulty in coordinating movement of their limbs.<br />
  • 9. <ul><li>Complete Spinal Cord Lesion</li></ul>Paraplegia <br />- paralysis of the lower body<br />Quadriplegia <br />- paralysis of all four extremities<br />
  • 10. Diagnostic Tests<br />X-ray - for lateral cervical spine<br />
  • 11. CT Scanner - performed initially<br />
  • 12. MRI -if a ligamentous injury suspected <br />even absence of bony injury<br />
  • 13. Electrocardiographic Machine <br />– for cord injury bradycardia and asystole<br />
  • 14. Emergency Management<br /><ul><li>the patient must be in a neutral position
  • 15. control the patient’s head to prevent flexion, extension, or rotation
  • 16. slide the victim carefully into a board when transferring to avoid any twisting movement
  • 17. maintain the extremities in an extended position
  • 18. patient can be moved to a conventional bed or placed in a cervical collar and on a firm mattress with a bed board under it</li></li></ul><li>Management of Spinal Cord Injuries <br />(Acute Phase)<br />
  • 19. Regeneration Therapy - transplanting of fetal tissue into the injured spinal cord in hopes of regenerating the damaged tissue<br />
  • 20. Pharmacologic Therapy<br />Methylprednisolone - improve motor and sensory outcomes at 6 weeks, 6 months, and 1 year if given within 8 hours of injury<br />
  • 21. Respiratory Therapy<br />
  • 22. Skeletal Fracture Reduction and Traction<br />Cones Caliper<br />Cervical or neck Traction<br />Tractions<br />Gardner-Wells Tong<br />
  • 23. Surgical Management<br />Surgery is indicated in the following instances:<br /><ul><li>compression of the cord is evident
  • 24. injury involves a wound that penetrates the cord
  • 25. there are bony fragments in the spinal canal
  • 26. patient’s neurologic status is deteriorating
  • 27. injury results in a fragmented or unstable vertebral body</li></li></ul><li>Planning and Goals<br /><ul><li>improved breathing pattern and airway clearance
  • 28. improved mobility
  • 29. improved sensory and perceptual awareness
  • 30. maintenance of skin integrity
  • 31. relief of urinary retention
  • 32. improved bowel function
  • 33. promotion of comfort
  • 34. absence of complications</li></li></ul><li>Nursing Interventions<br /><ul><li>Promoting Adequate Breathing and Airway Clearance
  • 35. Improving Mobility
  • 36. Promoting Adaptation to Sensory and Perceptual Alterations
  • 37. Maintain Skin Integrity
  • 38. Maintaining Urinary Elimination
  • 39. Improving Bowel Function
  • 40. Providing Comfort Measures
  • 41. Monitoring and Managing Potential Complications
  • 42. Promoting Home and Community-Based Care</li></li></ul><li>

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