Flashcards in trauma-spinal cord, ortho, abdominal injuries Deck (90)
Leading cause of death in spinal cord injuries?
6 conditions highly coordinated with spinal cord injuries/
paralysis, pain, position, paresthesias, ptosis, priapism
Is there a way to reverse the initial CNS damage in sc pts?
Most common avoidable complications in sc injury pts contributing to further damage?
ischemia d/t hypoexmia, hypotension, tissue swelling, delay in treatment
What should the radiologic assessment of the sc victim include?
lateral and AP C spine, open mouth X ray, T spine, L spine
What view is necessary if C7 is not visualized?
Is spontaneous movement or response to pain indicative of only spinal cord injuries?
no-head injuries too
What type of exam should be included in the sc injury pt?
What is pentaplegia?
SCI at junction of brain stem and spinal cord, phrenic nerve paralysis
What is respiratory quadriplegia?
lesions at C2-C3, sparring the upper most cranial nerves, paralysis of phrenic nerve and nerves that innervate the accessory muscles of respiration
What do cervical lesions below C4 mean in relation for respirations?
partial ftning of phrenic nerve, so some degree of voluntary resp control, VC 20-25% of what they should be
What do cervical lesions below C6 mean for respiratory control?
full diaphragmatic control, accessory muscle can be affected and expansion of rib cage from accessory muscle accounts for 60% of TV
What is Ondine's curse?
spontaneous ventilation only occurs with voluntary effort so breathing ceases when sleeping, it occurs after surgical or traumatic injury to the spinal cord at level C2-C4
How long does spinal shock after a spinal cord injury last?
Acute SCI Shock: extent of hypotension is related to?
level of SCI and is more pronounced in cervical lesions
Why does hypotension occur in acute SCI shock?
loss of vascular tone and preload
Why is bradycardia noted in cervical regions?
predominance of vagal tone in cervical region
Where are the cardioaccelerator fibers?
What are some cardiac dysrythmias associated with acute SCI?
brady, p wave changes, increased PR intervals, ectopic beats, CHB
3 HD changes associated w acute SCI?
bradycardia, irregular respirations, hypotension
What type of SCI pt should you avoid suxxs in?
Suxxs is safe to use in SCI what days after injury?
4-7 days after
If traction is not in place, what must be done during airway management by one person?
If the pt has a partial neuro deficit or none, what do you have to keep in mind about intubation?
awake intubation desirable to neuro assess can be done again after intubation
Hypotension resolves usually how many hours after SCI?
The most profound episodes of bradycardia happen on what days after the SCI?
3rd-5th post injury days
What is important to maintain flow to the sc?
SCI should have what HD monitor?
Lesions above what level abolish phrenic nerve ftn and require mech vent?