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Spinal Trauma

Injury that partially or completely servers the spinal cord Transection Cord Injury
Injury that causes Quadriplegia, Incontinence, and Respiratory paralysis. Cervical Spine Injury
Injury produces incontinence and paraplegia. Below T-1
Brown Sequard 's syndrome - causing loss of sensation and movement to that side of the body. Incomplete. Partial cut to spinal cord.
Signs and symptoms of cord injury Extremity paralysis. Pain with and without movement. Tender along spine. Impaired breathing. Spinal deformity. Priapism. Posturing. Loss of bladder or bowel control. Nerve impairment to extremities.
What is neurogenic shock? Spinal-Vascular Shock. Occurs when injury to spinal cord disrupts the brains ability to control the body. Loss of sympathetic tone. Dilation of arteries and veins. Expands vascular space. Results in hypotension. Unable to control release of epi&norepi.
Signs symptoms of neurogenic shock Bradycardia. Hypotension. Cool, moist, pale skin above the injury. Warm, dry, flushed skin below the injury. Males-priapism.
Methylprednisolon (solu-medrol) Reduce capillary dilation and permeability. Loading dose 30 mg/kg over 15 mins. Maintenance dose 5.4mg/kg/hr over 23 hours.
Dexamethason (Decadron, Hexadrol) Reduce capillary dilation and permeability, 5x's more potent than Solu -Medrol. 4-24mg.
PASG Controversial. Research shows no positive outcome.
Dopamine 2-20mcg/kg/min titrated to blood pressure.
Atropine 0.5-1.0 mg every 3-5mins (maximum dose 2mg)
Medications and the combative pt. Consider sedatives to calm pt. Prevents spinal injury aggravation. Meperidine (Demerol). Diazepam (Valium). Consider paralytics.
Created by: Mistymedic



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