Surgery or not If the scans show spinal cord compression (like a bone pressing on the cord), or the spine is unstable, surgery is usually done within hours if possible. The surgeon will likely discuss this with the family (or it may happen emergently). In some cases of cervical injury, they may operate through the front of the neck to fuse vertebrae; in other cases, from the back or both. If multiple vertebrae are broken, there may be several levels of fusion. After surgery, the patient might be kept sedated for a day or so or awakened sooner – it depends on their condition. If surgery isn’t needed (say, the spine is stable, and the cord injury came from a bruise that surgery can’t fix), the patient might be managed in a brace. The care team will explain whichever approach is taken. Communication in ICU The patient might be sedated or on a ventilator and unable to speak initially. They may be awake but groggy. Always assume they can hear you – speak reassuringly. ICU staff often allow family to be present in limited numbers once the patient is stable. Ask the nurses about visiting rules. Assign one family member as the point of contact to get updates by phone if you can’t be there constantly. Decision-making Early on, the family may need to help with decisions, especially if the patient is a child or is unconscious. These decisions could include consenting to surgery or procedures. The medical team will explain the risks and benefits. In life- threatening scenarios, they might proceed under emergency protocols, but usually, they will involve the next of kin for consent. If you’re asked to sign consent for surgery, it’s standard procedure – make sure you understand what the surgery entails. Questions to ask might be: What is the goal of the surgery? What are the risks? What happens if we don’t do it?
What families should expect in the hospital In the first days, expect a lot of ups and downs. SCI patients can have unstable blood pressure, fever, or other issues like spinal cord swelling that might cause the level of paralysis to worsen temporarily. They will be on medications to manage pain and prevent blood clots (often, blood thinners are started to reduce the risk of deep vein thrombosis since the patient can’t move legs). The healthcare team is interdisciplinary: you’ll interact with trauma surgeons, neurosurgeons or orthopaedic surgeons, critical care doctors, nurses, respiratory therapists, physiotherapists (even in ICU, they help with lung care and gentle movement), and perhaps a social worker or case manager fairly soon. Managing emotional shock and stress The moment you hear that you or a loved one has a spinal cord injury is often devastating. It is normal for the injured person, if conscious, or family member to experience shock, denial, fear, anger, and profound sadness. You are essentially grieving the sudden loss of the life you knew before. Recognise that this is a healthy grieving process – allow yourself to feel the emotions. You might find yourself on an emotional rollercoaster: hopeful one minute, despairing the next. This is common.
8
IMMEDIATE ACTIONS AFTER A SPINAL CORD INJURY
Made with FlippingBook Digital Publishing Software