Spinal Cord Injury

2. A spinal cord injury (SCI) is
damage to the spinal cord that
causes temporary or permanent
changes in its function. Symptoms
may include loss of muscle
function, sensation, or autonomic
function in the parts of the body
served by the spinal cord below
the level of the injury

3. A spinal cord injury (SCI) is
damage to the spinal cord that
causes temporary or permanent
changes in its function.
A spinal cord injury (SCI) is
damage to the spinal cord that
will leads to the temporary or
permanent alternations the
functions.

4. Spinal cord injury (SCI) is a
major health problem.
Nearly
200,000 people in the United
States live each day with a
disability from SCI,
an estimated 11,000 new
injuries occurring each year.
SCI occurs almost four times
more often in males than
females.

5.  Road traffic accident
 Bullet or stab wound
 Traumatic injury
 Electric Shock
 Extreme twisting of the
middle of the body
 Landing on the head
during a sports injury
 Fall from a great height

6.  Complete
In a "complete" spinal injury, all functions
below the injured area are lost, whether or not
the spinal cord is severely injured
A complete spinal cord lesion can result in
paraplegia (paralysis of the lower body) or
quadriplegia (paralysis of all four
extremities).

7.  Incomplete
An "incomplete" spinal cord injury
involves preservation of motor or sensory
function below the level of injury in the
spinal cord.
Classified according to the area of
spinal cord damage: central, lateral,
anterior, or peripheral

11. Emergency sign & Symptoms
 Extreme back pain or pressure in your neck, head or back
 Weakness, incoordination or paralysis in any part of your body
 Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
 Loss of bladder or bowel control
 Difficulty with balance and walking
 Impaired breathing after injury
 An oddly positioned or twisted neck or back
ACCORDING TO AFFECTED AREA
 C-1 to C-3: Tetraplegia with total loss of muscular/respiratory function.
 C-4 to C-5: Tetraplegia with impairment, reduced pulmonary capacity, complete
dependency for ADLs.
 C-6 to C-7: Tetraplegia with some arm/hand movement allowing some independence in
ADLs.
 C-7 to T-1: Tetraplegia with limited use of thumb/fingers, increasing independence.
 T-2 to L-1: Paraplegia with intact arm function and varying function of intercostal and
abdominal muscles.
 L-1 to L-2 or below: Mixed motor-sensory loss; bowel and bladder dysfunction

12.  Respiratory
 Total loss of respiratory muscle function
 Atelectasis
 Pneumonia
 Pulmonary edema
 Cardio vascular
 Bradycardia
 Hypotension
 Urinary system
 Urinary
retention
 Infection
 Atonic bladder
 Gi system
 Hypomotility
 Paralytic ileus
 Stress ulcer
 Intra-abdominal bleeding
 Integumentary system

Decreased sensation
 Muscle atrophy in flaccid
paralysis
 Pressure ulcer
 Contractures in spastic
paralysis
 Increased temperature
 Musculo skeletal system

Paralysis of one side of the bodyor upper or
lower limb

13.  HISTORY TAKING
 PHYSICAL EXAMINATION
 Computed tomography
 MRI
 EMGMyelography is a type
of radiographic examination that uses
a contrast medium to detect pathology of
the spinal cord, including the location of
a spinal cord injury, cysts, and tumors.
Historically the procedure involved the
injection of a radiocontrast agent into
the cervical or lumbar spine, followed by
several X-ray projections.

14. Computed tomography
MRI
X- Ray
MRIMRI

15. Goal
 To prevent the further damamage
 To prevent complications by
symptomatic management
 To achieve maximum level of function

16. Medical
 Emergency life support to maintain vital
functions
 Maintaining patent airway
/Intubation/Oxygen administration
 Neurological assessment
 Immobilization by traction or cervical
collar or cervical supports
 Urinary Catheterization
Pharmacological
 Corticosteroids in first24 hours after injury
to avoid inflammation & edema -
methylprednisolone 30mg/kg 8 hourly
 Vasopressin – dopamine
 Atropine
 Adrenaline
 Antacids & antihistamines

18.  Surgical management
 surgery is necessary to remove fragments of bones, foreign objects,
herniated disks or fractured vertebrae that appear to be compressing
the spine. Surgery may also be needed to stabilize the spine to prevent
future pain or deformity.
 Decompression laminectomy by anterior cervical thoracic approach
 Posterior laminectomy

20.  Monitor the condition of the
patient [continuous
assessment of neurologic
function ]
 Maintenance of proper
posture of cline and the
proper immobilization of neck
and spinal cord
 Provision the medical care in
the aspect of saving life : CAB
 Provide psychological support
to the patient & family

21.  Risk for Ineffective Breathing Pattern
 Acute Pain
 Impaired Physical Mobility
 Disturbed Sensory Perception
 Impaired Urinary Elimination
 Constipation
 Anticipatory Grieving
 Situational Low Self-Esteem
 Deficient Knowledge
 Risk for Autonomic Dysreflexia
 Risk for Impaired Skin Integrity
 Risk for Trauma

25. BOOK REFERENCES
1. BASVANTHAPPA, MEDICAL SURGICAL NURSING, 2NDEDITION, JAYPEE
PUBLISHERS,NEW DELHI
2. BRUNNER AND SUDDARTHS, TEXT BOOK OF MEDICAL SURGICAL NURSING,
11NTHEDITION, LIPPINCOTT WILLIAMS AND WILKINS, WOLTER KLUWER (INDIA)
PVT LTD,2008
3. DANIIEL RICK et-al, CONTEMPARARY MEDICAL SURGICAL NURSING, 2NDEDITION
2007, SWAT PRINTERS,
4. DONNA D Et-al, MEDICAL SURGICAL NURSING, 2ndEDITION WB SAUNDERS COMPANY

26. 5. ELIZEBATH A MARTIN Et-al
MINI DICTIONARY FOR NURSES, OXFORD UNIVERSITY PRESS.
6. JAYA KURUVILA, ESSENTIALS OF CRITICAL CARE NURSING, JAYPEE
BROTHERS MEDICAL PUBLISHERS PVT LTD, NEWDELHI , 2007.
7. JOYCE M BLACK, Et-all, MEDICAL SURGICAL NURSING,CLINICAL
MANAGEMENT FOR POSITIVE OUTCOMES, 8THEDITION,ELSAVIER INDIA
PVT LTD, 2010.
8. MOSBY, 2006 DRUG CONSULT FOR NURSES, ELSAVIER PUBLICATIONS
2006.
9. NANCY HOLMES Et-al, MASTERING MEDICAL SURGICAL NURSING
DISORDERS & TREATMENT & NURSING TIPS ANDGUIDELINES PATIENT
TEACHING AND OUT COME, SPRINGHOUSE .
10. SANDRA N NETTINA, THE LIPPINCOTT MANUAL OF NURSING
PRACTICE, 7NTH EDITION, LIPPINCOTT PUBLISHERS, PHILADELPHIA,
2003.

27. INTERNET REFERENCES
https://www.mayoclinic.org/diseases-conditions/spinal-cord-
injury/diagnosis-treatment/drc-20377895