Neurological System – Nursing Interventions for Acute Spinal Cord Injury

00:01 Okay. Now let's look at what you'll be seeing in your patient.

00:04 The clinical manifestations of a spinal cord injury, system by system. Okay? We're gonna start with neurological and work our way through all of these systems you see on the slide.

00:16 Okay. So neurological, I want you to think, motor and sensory.

00:22 Remember, those are the neuron's we have that we're playing with, that we're dealing with; motor and sensory.

00:27 So the American Spinal Injury Association, they have an impairment scale.

00:32 That's something that can help us assess that and document it.

00:36 See, this scale takes assessment of motor and sensory function to kinda look at the neurological level and the completeness of the injury.

00:43 So it's very helpful when we record changes and identify exactly where the patient is and what rehab goes we're gonna have for them.

00:52 Okay. Their scale goes from A to E.

00:55 I know, it's another alphabetical skill, but it seems pretty popular in medicine, doesn't it? 'A' means there's no motor or sensory functions preserved in the sacral segments S4-S5.

01:06 'B' you have sensory but no motor function is preserved below the neurological level and includes sacral segments S4 and S5.

01:15 Now 'C' motor function is preserved below the neurological level and more than half of the key muscles below the neurological level have a muscle grade less than three.

01:25 The difference in 'D' is they have a muscle grade of three or more.

01:30 Now finally in E, motor and sensory function are normal.

01:34 So hopefully that's like you or I.

01:37 The only thing I will remember that in this case, A is a no-bueno.

01:42 That's no good. E is the most normal and you've got B, C and D in between.

01:48 So the most important take away from this slide is knowing that there's a standardized scale that we use and it's to look at motor and sensory.

01:56 'A' being the worse severe impact, 'E' being normal.

02:01 Now let's talk about the dermatome, it helps us with sensory regions.

02:05 Each spinal cord segment innervates at a particular area of the skin that's why you hear this called a dermatome.

02:13 You can see how there's a lot of complicated looks like in there, but it's very simple.

02:17 Just to show you that there's a very specific regions that each spinal cord segment innervates.

02:23 Now we can use these regions for testing.

02:26 You can see we've got the dermatome on the front side and the backside just for your review.

02:32 But this will help us tie the injury and the symptoms help us with better diagnosis and planning for the patient's care.

02:39 So, let's look at neurological motor and sensory and see what do we do as a nurse.

02:45 Well, you're gonna have to be really thorough on your neuro assessments.

02:49 You'll do a very thorough and regular neuro assessments on patient who've had a spinal cord injury.

02:54 You're gonna watch and document changes, look for trends and make sure that you notify the healthcare provider when something significant happens because our role as a nurse is to be the eyes at the bedside.

03:07 So, thorough neuro assessments and done regularly.

03:11 And make sure you document changes and trends in clear, concise and objective language.