EMERGENCY ROOM MANAGEMENT IN SPINAL CORD INJURY
Abstract:
The initial examination of a trauma patient with suspected spinal trauma is performed in
Emergency Room. The goals of initial examination and treatment of spinal cord injury are: to realign
the spine, to prevent loss of function of undamaged neurological tissue, to improve neurological
recovery, to obtain and maintain spinal stability and to obtain early functional recovery. In according
with this reason in Emergency Room is need to perform a complete clinical and neurological exam of
patient with spinal injury used the ASIA/IMSOP (American Spine Injury Association/International
Medical Society Of Paraplegia) principles. We have to study the following aspects: Immobilization of
the patient with suspected spinal injury; Compensation of hypotension; Adequate oxygenation of the
patient; Abdominal decompression; Imaging investigation of patients with suspected fracture of the
spine: X-ray examination, CT-scan and MRI for patient with spine trauma; Neurological assessment of
patients with spinal trauma: checking both the motility function and the sensory one, to determine the
degree of damage, according to the criteria of scale offered by ASIA / IMSOP. Is a good reason for
introduction of an neurological evaluation record of the patient with spine fracture that give direct,
objective data (not only quantitative, how neurological clinical examination offers) on the degree of
neurological damage and which is also intended to be a useful tool for the prompt evaluation of the
evolution of the case. The role of this objective, systematic and dynamic evaluation transposes into
shaping the therapeutic decision. Thus, by assigning the initial clinical evaluation data with the data of
the imagistic examination and with those objective data offered by the neurological evaluation the best
therapeutic protocol may be chosen to offer the best chances of complete recovery of patients with spine
fractures and the rehabilitation of their economic and social life. The chances of such a patient of
complete healing without neurological sequelae increase considerably if, at the first contact with the
patient in the Emergency Room the correct decisions can be taken quickly, and I mean decisions
regarding the initial assessment (clinical, neurological, imagistic), and the rapid introduction of the
patient in a therapeutic protocol that will give the best chance of complete healing without sequelae.
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