IMMEDIATE ACTIONS AFTER A SPINAL CORD INJURY
The period right after an SCI – from the incident through the hospital acute care, is emotionally exhausting for families. Knowing what to expect can help. This section covers what decisions you might face, questions to ask, and coping with the initial shock.
At the scene Paramedics will immobilise the spine. Often, the person is taken to a major trauma centre if the injury is suspected to be serious. Once in the emergency department, a trauma team will evaluate all injuries (because spinal injuries often accompany other trauma). They will likely do X-rays or CT scans, start IV lines, and possibly intubate the patient if there are breathing issues. The family might be asked what happened, any medical history, etc. If life- saving measures or surgery are needed, you may not see the patient immediately. Intensive Care Unit (ICU) Many spinal cord injury patients, especially with cervical injuries, go to the ICU initially. In the ICU, they closely monitor heart rate, blood pressure, oxygen, etc. Don’t be alarmed by the number of machines and tubes – these help the team care for your loved one.
C ommon things you might see in the ICU: A ventilator (breathing machine) if they can’t breathe fully independently. IV lines delivering fluids, pain medication, blood pressure support, etc. Possibly an arterial line (a thin tube in an artery) to monitor blood pressure continuously. A urinary catheter to drain the bladder (standard for virtually all SCI patients initially, since they likely can’t control the bladder). Perhaps a nasogastric (NG) tube can be used through the nose to the stomach if the person can’t eat yet. They may be in a neck collar or on a special bed that rotates to prevent pressure sores. The ICU staff will work to stabilise vital signs and prevent complications. One potential complication in high SCI is neurogenic shock (as discussed, causing low blood pressure), so they’ll be managing that with fluids and meds. Another is difficulty breathing or pneumonia, so they keep the lungs clear with suctioning and respiratory therapy.
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