ABCD: Disability and Imaging – Nursing Care for Acute Spinal Cord Injury

00:01 So we've looked at airway, breathing, circulation.

00:05 Now we're down to the D, for disability. So always thinking about the neurologic status and not extending the injury.

00:13 So, we wanna make sure, until you know what the status is of that spinal cord.

00:17 In the patients brought into ER, they're gonna have to figure out, "Does the patient have a spinal cord injury or not?" So until they can rule that out, they keep the neck immobilized.

00:27 Now, you'll read, there's a lot of controversy row, "What should we use? Shall we use collars or not?" So there's a lot of discussion going on about that.

00:35 But, our idea is - the goal here is that we wanna keep that patient in a neutral place.

00:42 So whatever the policy is in your area, in your hospital, a lot of times it's a cervical collar.

00:47 You wanna make sure that you keep that neck in a neutral place.

00:51 Athletic headgear. If this happened on an athletic event, and let's say happened at a football game and the athlete is wearing a helmet, leave the helmet on, don't take it off.

01:02 Because remember, the goal is, a neutral position of the neck, whatever it takes to get them in that.

01:08 So, we talked about airway, breathing, circulation and disability, neurologic status.

01:14 Remember, if a spinal cord injury is suspected, you wanna do everything you can to protect that spinal cord and keep it in a neutral position until it can be ruled out in an emergency setting.

01:25 Now we're gonna look at how that injury is actually ruled out.

01:31 Many trauma patients have cervical spine imaging to rule out traumatic spinal cord injury.

01:36 So let's talk about what the imaging studies are.

01:39 You might do - see them do a cervical x-ray.

01:43 After they do a neuro assessment and they're concerned about a possible injury, I can now begin a really rapid assessment of alignment and fractures and if there's some soft tissue swelling.

01:53 So, cervical x-ray maybe the first thing they do. CAT scan, depending on how quickly they can get there will show bone damage.

02:00 And an MRI; magnetic resonance imaging; after the spine is stabilized might show the extent of the spinal cord damage.

02:09 So these are three very common tests; cervical x-rays, CAT scan and MRI.

02:15 Remember when you're taking a patient to MRI, no metal, not for you or for the patient because the M stands for magnetic.