SPINAL SHOCK / SPINAL CORD INJURY

Scenario:The young lady in the image above,
fell off her horse. She sustained a spinal injury.
Spinal shock may be caused by hyperextension
or hyperflexion of the spinal column.Vasogenic
shock may also occur, leading to vasodilation
of the blood vessels, hypotension and bradycardia.

Central cord syndrome typically involves the central
part of the spinal cord. This unusual phenomenon
causes weakness of the upper extremities and minimal
or no weakness of the lower extremities.

To learn more, please click on the link below:
Defining dermatomes

SCI ( spinal cord injury)

 

CENTRAL CORD SYNDROME / BROWN SEQUARD SYNDROME

Updated 8/25

Scenario:The young lady in the image above,
fell off her horse. She sustained a spinal injury.
Spinal shock may be caused by hyperextension
or hyperflexion of the spinal column.Vasogenic
shock may also occur, leading to vasodilation
of the blood vessels, hypotension and bradycardia.

Central cord syndrome typically involves the central
part of the spinal cord. This unusual phenomenon
causes weakness of the upper extremities and minimal
or no weakness of the lower extremities.

   Brown Sequard syndrome is a rare condition.

   Penetrating wounds like stab wound to the back
   or neck, a tumor which may obstruct blood flow,
   to the spine, may cause this condition.

  Hemisection of the spinal cord results in loss of
  motor control on one side and loss of sensation
  like temperature, on the other side.

 

 Learn more: Spinal injury

DEFINING DERMATOMES

 

SPINAL COLUMN

The spinal column is made up of a collection of bones that
protect the spinal cord. There are disks between the bones.
There are nerves in the spinal cord that originate from the 
brain.

SPINAL INJURIES 
Injury to the spinal cord, may result in decreased sensation
to the extremities and torso.

CHECKING DERMATOMES

Checking dermatomes, is usually done by using a pin

and cautiously pricking the skin of the arms, fingers, 

legs and feet. In addition, asking the patient if the 
sensation is dull, sharp or absent.

It is important to document findings.

Enjoy watching the video:

Spinal trauma

What does SCI mean?
SCI means Spinal cord Injury.

What impact might this have on the spinal column?
It is important for the nurse to document her findings, when 
an assessment is done. 

Here are some of the problems that may result from SCI:
- injuries above C3 may affect breathing
Mechanical ventilation may be necessary
- C3 - C7 will involve some degree of weakness involving
shoulders, arms, hands and fingers
- T 1-T12 injuries may paraplegia
- L1- L5 injuries may affect the thighs, knees, feet and toes
See above for more info.

SPINAL SHOCK (WHAT IS IT )

 Updated 2/24

 Dear nurses,

Injury to the spinal column may not be easy to diagnose

 at the scene of the accident. The spinal column has a high
network of nerves which control blood pressure. 

 

Injury to the spinal cord will result in blood flow being affected

and ultimately a change in blood pressure. IV Fluid replacement
therapy and drugs such as Dopamine, may be necessary to correct
hypotension. IV Steriods may be ordered by the doctor, to decrease
swelling around the spinal cord and reduce further damage.

What is the vertebral column made of ? 

The  vertebral column is made up of :
7 cervical , 12 thoracic, 5 lumbar,
5 sacral and  4 coccyx [which are 
fused together] vertebrae.

Documentation and assessment of paralysis is
a nursing responsibility. 

To learn more about spinal cord injury and
assessment, please click on
the link: Defining dermatomes

SPINAL INJURY

                                     

What does SCI mean?
SCI means Spinal Cord Injury.

What impact might this have on the spinal column?

Here are some of the problems that may result from SCI:
- injuries above C3 may affect breathing
Mechanical ventilation may be necessary
- C3-C7 will involve some degree of weakness involving
shoulders, arms, hands and fingers
- T 1-T12 injuries may paraplegia
- L1-L5 injuries may affect the thighs, knees, feet and toes

It is important for the nurse to document her findings
 when an assessment is done. 
For more information, please click on the link:

Defining dermatomes

   

Injury to the spinal cord following trauma may result in shock.
For more helpful information, enjoy the video:

Emergency room experience.

WHAT HAPPENS WHEN THERE IS A SPINAL INJURY

    Scenario

   Three friends are out hiking on a nature trail.Sad to say, one
    sustains a fall and subsequently injury to the spine. As they
    work to provide a safe place to rest and comfort their friend,
    they are also trying to figure out, how to get him to the hospital.

When someone is involved in a traumatic event,
whether a  car accident , burns,fall, impaled object,
or cardiac event and more, the standard of care will 
depend on the severity of the injury or injuries.

Sometimes trauma may occur in a rural area or one 
where a higher skill level is not readily available.
For this reason, services such as a helicopter may
be necessary to transfer the patient to a higher level of care.

Learn more about : Dermatomes and  Quiz question

Learn more about : Spinal cord injury

              

CARE PLANNING A NECESSARY PART OF THE NURSING PROCESS

Scenario: Mark sustained a traumatic brain injury while surfing.
He had an EVD ( external ventricular device) inserted and ICP
monitoring ordered by the doctor. His family members are very
anxious as, no one has taken the time to explain what is happening.
There is an obvious need for family education.

Helpful info for the layperson

Care planning:
Below are some potential problems:

- anxiety related to illness and lack of knowledge
- infection related to EVD insertion
- neurological changes related to brain injury
- fever related to brain injury
- pain related to injury

* Always follow your MD orders and Institution's policies and procedures 

Enjoy watching the video:

Care planning

Learn more about: Spinal injury
 

THE EMERGENCY ROOM

Clinical scenarios

Above are clinical scenarios that each tell their own story.
Just click on the link above for more helpful information.

Updated 1/25

                                                           Eye injury

An eye injury may occur at anytime and anywhere,
sometimes in the workplace. It is important to recognize
that quick intervention is of paramount importance.

Helpful hints:

Always lift try to lift large objects away from the eyes.
If something splashes in the eye, washing it out of the eye and
seeking medical treatment may be necessary.

Hyphema - Blood in the anterior chamber of the eye caused by
blunt trauma.(See image).

                                                             

                                                                    Spinal injury

Scenario: Jim had a few extra drinks to celebrate his birthday.
He dives into the shallow end of the pool. Unfortunately, he will
have to be taken to the Emergency Room for further treatment.

                                Emergency Room vs. Urgent Care

Recently there have been changes in the way emergencies
are handled. Some situations are minor and do not need
        a high level of care. Triage is very important in distinguishing
how to filter patients to the right facility.

Minor cuts, bruises, infection and less severe pain may be treated in 

an Urgent Care. More severe conditions like burns, head and spinal 
trauma, stroke symptoms and a cardiac event may require a higher
level of care like an Emergency Room.

DERMATOMES IN SPINAL INJURY

Updated  6/25

Dear nurses,

Dermatomes is done to check the sensation of the patient 

post spinal injury.

Please click on the link for more updated version:

Defining dermatomes

Dearnurses.com is no longer available. Abdominal Aortic Aneutysm may result

from hypertension. A stroke may also result from hypertension.

Assessment of these nerves is shown in the image above.

Learn more about : Cranial nerves

ADDRESSING SPINAL SHOCK

Updated 7/25

Injury to the spinal column may not be easy to diagnose

 at the scene of the accident. The spinal column has a high
network of nerves which control blood pressure. 

Injury to the spinal cord will result in blood flow 

              being affected and ultimately a change in blood pressure.

    IV Fluid replacement therapy and drugs such as
    Dopamine, may be necessary to correct hypotension.
                                         

IV Steriods may be ordered bythe doctor, to decrease
      swelling around the spinal cord and reduce further damage.

Learn more about: Triage nurse

Learn more about : Sepsis

Just click on the link :

Emergency Room experience

Enjoy learning!

CENTRAL CORD SYNDROME

Scenario: In the image below, Henry
dove into a pool and sustained a spinal
cord injury. This resulted in Central
Cord Syndrome.These are:
- loss of motor control of upper
  extremities
- full use of lower extremities

Central cord syndrome typically involves the central
part of the spinal cord. This unusual phenomenon
causes weakness of the upper extremities and minimal
or no weakness of the lower extremities.

Learn more about: Spinal injury and the AED

ASSESSMENT FROM HEAD TO TOE (PART1)

Updated 12/24

Dear nurses, 

The following topics can be accessed by clicking on the links below:

- Stroke assessment

- aspiration pneumonia

- cranial nerves

- spinal cord injury

Enjoy the video :

Assessment from head to toe




              Spinal injury

SPINAL CORD INJURY

                          Dearnurses.net is no longer available.

Updated 3/25

Dear nurses,

  Sara above was enjoying ice skating, when she
 lost control and fell on her back. She sustained
a spinal injury. Learn more, by clicking on the
link: SCI

SPINAL SHOCK

Updated  8/23

The patient above, has sustained a spinal injury.
To learn more about this topic,
please click on the link:

An Emergency Room experience
Enjoy learning.

BROWN SEQUARD SYNDROME

Updated 6/25

   Brown Sequard syndrome is a rare condition.
   Penetrating wounds like stab wound to the back
   or neck, a tumor which may obstruct blood flow,
   to the spine, may cause this condition.

  Hemisection of the spinal cord results in loss of
  motor control on one side and loss of sensation
  like temperature, on the other side.

    Learn more: Spinal injury

In the above image, examples of how brain injuries
can occur are shown. Click on the links:
ICP monitoring

Stroke and ICP

for more information.

DEFINING TRAUMA CARE

How do you treat trauma?

When someone is involved in a traumatic event, whether car accident, burns, fall, impaled object, or cardiac event and more, the standard of care will depend on the severity of the injury or injuries.

Sometimes trauma may occur in a rural area or one where a higher skill level is not readily available. For this reason, services such as a helicopter service may be necessary to transfer the patient to a higher level of care.

Learn more about: Spinal injury

How are the four levels of trauma categorized?

Level I: Offers 24-hour services of highly skilled staff, resident doctor on call, and can absorb trauma patients around the clock. They also include research and education programs.

Level II: Trauma center usually works in conjunction with a Level I trauma center and has 24-hour services. However, this level is not required to have a resident on call or a research program.

Level III: Does not have 24-hour service but has an intensive care and a surgical suite. Patients requiring a higher level of care would have to be transported to Level I or Level II.

Level IV: Works to stabilize injured patients who are far away and there are no other services.

 

Scenario: Trauma patient was air lifted to Level I trauma center. Special trained staff assisted in the effort.

PHARMACOLOGY FOR NURSES IN THE CLINICAL SETTING

Dear nurses,

We have reached the final chapter.

Topics are:

Spinal Injury, Solumedrol its uses and

side effects

Swimmer's Ear, Ciprodex

COPD, Bronchodilators, Albuterol,

Terbutaline Sulfate

Please click on the link and enjoy learning:

Pharmacology for nurses- Chapter 9.

CAN TRAUMA HAPPEN INSIDE A TRAUMA

Updated 5/24

Dear nurses,

Dear nurses.com is no longer available. New links have
been added, to make learning easy.

When a trauma patient arrives in the Emergency Room,

it takes "all hands on deck" to help with this situation.

It is not uncommon for medical staff members to be

called from other areas of the hospital to assist.

It is important to take great care while rushing to the

trauma, otherwise another trauma may happen.

Learn more: Spinal injury 

ELBOW FRACTURE AND ITS CONSEQUENCES

Updated 4/25

Scenario: Sara slipped and fell while playing tennis.
She was transported to the Emergency Room, for 
further evaluation. X-Ray of her elbow revealed 
a fracture. 

The elbow has a hinge joint. There are three bones
that make up the elbow : humerus, radius and ulnar.

Volkmann's contracture may further complicate a
fractured elbow. Poor circulation (ischemia) may
occur during the healing process.

Learn more, by clicking on the link:

Spinal injury

A PREVIEW OF WHAT'S TO COME

                    Dearnurses.net is no longer available.

Updated 7/25

Dear nurses,

New topics have been added below. 
Enjoy learning!

Here are some diagnostic tests that are done frequently.

Follow the links below:

1. Chest X ray
2. CAT scan
3. EKG
4. MRI scan
5. Ultrasound
6. Echocardiogram

Learn more about : Cranial nerves

Learn more about : Spinal injury

Be cautious, prevent falls!