Spinal Cord Trauma Management
Although CT should be considered initially for patients with concern for traumatic SCI, MRI is the gold standard for those with neurological deficits localizing to the spinal cord - Casey Thompson BS
HWN Suggests
We Have Your Back: ED Presentations, Evaluation, and Management of Spinal Cord Injuries
Due to the high impact causes of most spinal cord injuries, many patients present to the ED via Emergency Medical Services (EMS). Immobilization of anyone at risk for an SCI has been standard practice since the 1970s, despite the lack of evidence-based studies on its efficacy. There are known harms of immobilization, most notably airway compromise, aspiration, and ulcers from prolonged stays in immobilization devices. Despite controversy surrounding immobilization devices, they remain in widespread use due largely to the historical and legal precedent. In fact, no high-quality evidence supports use of these immobilization devices. Treatment recommendations include expediting the removal of…
Articles of Interest
Emergency Department Management of Cervical Spine Injuries
NEXUS and the Canadian c-spine rule: using clinical decision rules to determine who is safe to discharge without imaging.
Emergency medicine: The need for speed
Although doctors have long known that rapid treatment helps recovery, Fehlings says it is only in the past 25 years that we have started to understand just how crucial time is. He says that “a shift in practice” is emerging, based on research showing that the damage from a spinal cord injury can be limited by early action.
New Surgical Techniques Help Relieve Pain from Spinal Injury
For spinal cord patients, conventional pain therapies frequently fail, so often doctors suggest the pain is “in their head.” But, Falci says, it's actually in their spinal cord. He resolves it with surgery.
Tasty Morsels of Critical Care...
Like TBI we can split up spinal cord injury into primary and secondary injury. Primary injuries include direct mechanical injury like compression, haematoma, laceration, traction or even complete transection which is thankfully rare.
The Changing Standard of Care for Spinal Immobilization
New guidelines suggest a more limited role for prehospital spinal immobilization based on increasing evidence that the practice often is not only unnecessary, but possibly harmful.
