Week 3 SBL Learning Issues

Question 1

What are the five components of an AMPLE trauma history?

Answer 1

A: Allergies
M: Medication
P: Past Medical History
L: Last Meal
E: Events leading to injury

Question 2

How does the NEXUS criteria work? What are the five criteria?

Answer 2

If none of the five criteria are met, we can clear them from a c-spine injury:

1. Focal neurological deficit
2. Midline spinal tenderness
3. Altered level of consciousness
4. Intoxication
5. Distracting injury

Question 3

Spinal injuries at and above this spinal level can cause autonomic dysreflexia…

Answer 3

T6

Question 4

Describe autonomic dysreflexia

Answer 4

• Spinal injury at or above T6
• Noxious stimuli (e.g. indwelling catheter) below level of injury
• Afferent sensory signal is blocked at site of injury
• Triggers sympathetic response (inc. BP)
• Baroreceptors detect -> bradycardia
• Parasympathetic response above level of injury to counteract (flushing)

Question 5

Neurogenic shock vs spinal shock

Answer 5

Neurogenic: loss of sympathetic tone below level of injury, causing hypotension and bradycardia

Spinal shock: sudden loss of transmission (and therefore loss of reflexes and muscle tone) following spinal injury

Question 6

Describe a normal bulbocavernosus reflex

Answer 6

• Contraction of external anal sphincter in response to squeezing of penis/clitoris

Question 7

What is the assumed mechanism of priapism following spinal cord injury?

Answer 7

Loss of sympathetic innervation to the external genitalia

Question 8

What are the core components of short-term, clinical management of spinal cord injuries?

Answer 8

• Medication (anti-flam)
• Immobilization
• Surgery

Question 9

What investigations are indicated in all trauma cases?

Answer 9

• Glucose
• Urinalysis (blood)
• Hb
• CBE (baseline)
• Blood type

Question 10

Which professionals might be involved in spinal injury rehab?

Answer 10

• Physio
• Physiatrist
• OT
• Rehab psychologist