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Computerised Asia scoring for SCI- Nursing role

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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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