Cervical Spine Injuries

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Information about Cervical Spine Injuries

Published on March 10, 2012

Author: reynel89

Source: authorstream.com

Cervical Spine Injuries: Cervical Spine Injuries Kinna P. Siarro , RN PowerPoint Presentation: Injuries to the cervical spine are serious because the crushing, stretching, and rotational shear forces exerted on the cord at the time of trauma can produce severe neurologic deficits Edema and cord swelling contribute further to the loss of spinal cord function. Primary Assessment: Primary Assessment PowerPoint Presentation: Any person with a head, neck, or back injury or fractures to the upper leg bones or to the pelvis should be suspected of having a potential spinal cord injury until proved otherwise PowerPoint Presentation: Provide immediate immobilization of the spine while performing assessment. Airway. Breathing. Intercostal paralysis with diaphragmatic breathing indicates cervical spinal cord injury. PowerPoint Presentation: In conscious patient, observe for increased respiratory rate and difficulty in speaking due to shortness of breath. Circulation. Disability—assess neurologic status. Primary interventions: Primary interventions PowerPoint Presentation: Immobilize the cervical spine. Open the airway using the jaw-thrust technique without head tilt. If the patient needs to be intubated, it may be done nasally. PowerPoint Presentation: If respirations are shallow, assist with a bag-valve mask. Administer high-flow oxygen to minimize potential hypoxic spinal cord damage. Subsequent assessment: Subsequent assessment PowerPoint Presentation: Assess the position of the patient when found; this may indicate the type of injury incurred. Hypotension and bradycardia accompanied by warm, dry skin—suggests spinal shock. Neck and back pain/extremity pain or burning sensation to the skin. History of unconsciousness. PowerPoint Presentation: Total sensory loss and motor paralysis below level of injury. Loss of bowel and bladder control; usually urinary retention and bladder distention . Loss of sweating and vasomotor tone below level of cord lesion. Priapism—persistent erection of penis. PowerPoint Presentation: Hypothermia—due to the inability to constrict peripheral blood vessels and conserve body heat. Loss of rectal tone. General interventions: General interventions PowerPoint Presentation: NURSING ALERT A spinal cord injury can be made worse during the acute phase of injury, resulting in permanent neurologic damage. Proper handling is an immediate priority. PowerPoint Presentation: Insert an NG tube. Keep the patient warm. Initiate I.V. access. Insert an indwelling urinary catheter to avoid bladder distention . Monitor for hypotension, hypothermia, and bradycardia . Continue with repeated neurologic examinations to determine if there is deterioration of the spinal cord injury. PowerPoint Presentation: Be prepared to manage seizures. Pharmacologic interventions: high-dose steroids (methylprednisolone). The standard regimen is 30 mg/kg I.V. loading dose over 15 minutes, followed by a 5.4 mg/kg/hour infusion to be initiated 45 minutes later. Continue the infusion for 23 hours. PowerPoint Presentation: Thank You

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