Spinal Injuries
Spinal cord injury (SCI) occurs when a traumatic event results in damage to cells within the spinal cord or severs the nerve tracts that relay signals up and down the spinal cord. Spinal Cord Injury is damage to the spinal cord resulting in loss of function i.e. feeling and mobility. Most common causes of SCI are car accidents, sports, work accidents or disease, spina bifida, tumours etc. The most common types of SCI include contusion (bruising of the spinal cord) and compression (caused by pressure on the spinal cord). Other types of injuries include lacerations (severing or tearing of some nerve fibres, such as damage caused by a gun shot wound), and central cord syndrome.
Spinal cord
The spinal cord is a cylinder of nerve tissue that runs down
the centre canal in the spine. The nerve fibres in the spinal
cord transmit sensory information toward the brain and motor
signals to the appropriate parts of the body. The spinal cord
also handles some automatic motor responses to sensory
information by itself.
Cervical spinal nerves (C1 to C8)
These nerves (eight pairs) supply the back of the head, the
neck and shoulders, the arms and hands, and the diaphragm.
Thoracic spinal nerves (T1 to T12)
These nerves (12 pairs) supply the chest, some muscles of the
back, and parts of the abdomen.
Lumbar spinal nerves (L1 to L5)
These nerves (five pairs) supply the lower parts of the abdomen
and the back, the buttocks, some parts of the external genital
organs, and parts of the legs.
Lumbar spinal nerves (L1 to L5)
These nerves (five pairs) supply the lower parts of the abdomen
and the back, the buttocks, some parts of the external genital
organs, and parts of the legs.
Mechanisms of spinal injury
Spinal injuries should be assumed to be present until proven otherwise where:
- Unconscious patient involved in a RTC
- Patient with multiple trauma
- Significant injuries above the level of the clavicle (collar bone)
- Incident involving a fall from > 10 feet (or twice the height of the patient)
- Any accident when the impact forces are (or seem to be) high
- Acceleration or deceleration forces involved of the neck
Signs and Symptoms:
- Fading in and out of consciousness
- Extreme back pain or pressure in the neck, head or back
- Weakness, in coordination or paralysis in any part of the body
- Numbness, tingling or loss of sensation in the 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
Management
Support head and neck (Inline immobilisation), Avoid any rushed movements to prevent jarring and rotation of neck and limbs, Use a spinal board or vacuum mattress, Lift patient carefully using kinetics of lifting and correct equipment, Do not attempt to move a patient on your own if you suspect a neck or spinal injury.
ASHICE (Consider)
Transport to Hospital (Smooth journey to prevent further complications and discomfort)
Professional Handover