Spinal cord injury is an event that changes a person’s life forever. The classifications of spinal cord injuries are concussion, compression, contusion, laceration, and transection. Injury can be complete or incomplete (Nayduch., 2010). The type and location of the spinal cord injury will determine the care and management of the patient and subsequent complications that arise from the injury. The research will focus on evidenced-based medical, surgical, and nursing care from the onset of injury to rehabilitation.
Description of the Condition The spinal cord controls mobility, regulates organ function and transmits motor and sensory information to and from the brain. Neurons in the spine make up bundles known as the peripheral nerve roots, there are 31 pairs. The posterior branch carries the sensory information to the cord. The anterior branch transmits motor impulses to the body’s muscles. Each pair of nerves is named by the vertebrae that it exits from. There are eight cervical vertebrae C 1-8, twelve thoracic vertebrae T1-12, five lumbar L1-5, five sacral S1-5, and one coccygeal. Harm to the spinal cord causes disturbances in the signals. These disruptions can cause loss of sensory, motor, or autonomic function (Robinson & Wells, 2015). A concussion spinal injury is the severe jolting of the cord that may result in the temporary loss of function. Concussion symptoms usually disappear within hours to weeks. A contusion is a bruise bleeding into the column that can cause necrosis. (Robinson & Wells, 2015) Compression injury is caused at the moment of impact and distorts the spine’s normal curvature (Nayduch,2010). Laceration in the spinal cord is caused by a tear that results in permanent injury. Lacerations are followed by contusion, edema and compression of the cord (Nayduch, 2010). Lacerations may be caused by bone fragments or projectiles such as bullets. Transection is the severing of the cord. Therefore, a transection may be a complete loss of motor and sensory or an incomplete, partial loss of motor or sensory function (Robinson & Wells, 2015). Complete transection of the spinal cord produces losses below the level of injury flaccid paralysis of all voluntary muscles, loss of reflexes, loss of pain perception, light touch, temperature and pressure. Consequently, the absence of somatic and visceral sensations will cause the loss of the ability to perspire and bowel and bladder dysfunction (Nayduch, 2015). Incomplete transection of the spinal cord may have motor or sensory loss depending on the positioning of the damage. Anterior cord damage results in paralysis and sensory impairment to pain and temperature. Central …show more content…
Given the United States current population of 314 million there are approximately 17,000 new spinal cord injury cases each year.
There are roughly 282,00 Americans that are living with spinal cord injury (NSCISC, 2015). The National Spinal Cord Injury Statistical Center reported trends of spinal cord injury as 39.08% from vehicular accidents, 29.54% from falls, 14.41% acts of violence, 8.39% sports and recreation, 8.75% Other causes. The median age of injury has risen from 29 years old during the 1970s to 42 in 2015 (NSCISC,2015) When a spinal cord injury is suspected the person should not be moved, call for emergency services and let them immobilize the patient. The patient will stay immobilized and NPO until they have gotten computed tomography scan (CT scan), where the CT scan will show the location and extent of the injury. The patient remains NPO if surgery is indicative. Magnetic resonance imaging scans (MRI), and x rays. X rays may be enhanced with an injected contrast dye also may be used to diagnose the injury (Robinson& …show more content…
The post operation nursing care will include prevention of secondary injury as well as wound care (Nayduch, 2010). A prophylactic low molecular weight heparin dose will be given to prevent Deep Vein Thrombosis (DVT), along with sequential compression devices, and compression stockings. DVT prevention immediately after the injury are indispensable in patient management (Matsumoto., et al 2015). Low molecular weight heparin side effects include bleeding, thrombocytopenia, pain at injection site, report any signs of unusual bleeding or bruising to the provider. Keep in mind do not take concurrently with antiplatelet agents, use a soft toothbrush, use an electric razor, monitor CBC with platelets, and the antidote is protamine sulfate (Leek,