|
 If spinal cord injury (SCI) is suspected, patients should be transported to hospital immediately. Often, ambulance personnel will transport the patient. Ambulance personnel are trained in how to protect the patient’s spine in cases of suspected injuries. A hard, immovable collar will be placed around the patient’s neck and the patient will be strapped to a backboard to prevent movement. These measures are necessary to prevent further injury to the spinal cord.
Upon arrival at the hospital, the patient will have their vital signs monitored. Staff will assess the adequacy of the patient’s airway, breathing, and circulation. A history of the incident, the patient’s past medical history, and allergies will be obtained. During examination, the physician will be assessing for the following signs and symptoms:
- Severe pain in the back, head, or neck
- Tingling sensation in the patient’s extremities i.e. hands, fingers, feet, or toes
- Complete or partial loss of control of any part of the body
- Loss of control over bladder or bowel function i.e. urgency, incontinence, or retention
- Difficulty walking and balancing
- Pain or pressure around the chest
- Difficulty breathing
- Any obvious lumps or deformities of the head or spine
- Altered mental status
If after examining the patient the physician determines that a SCI may have occurred, appropriate diagnostic tests will be ordered. Routine blood work may be obtained.
Radiological Evaluation
X-rays-Often the entire spine is x-rayed. This can be done even if the patient is fully immobilized on a backboard. X-rays will show if there is any fracture or misalignment of the bones of the spine.
CT scan-In larger centers, the patient may proceed directly to CT scan, bypassing x-rays altogether. CT scans can visualize the bony anatomy of the spine, including any fractures.
MRI-MRI’s are helpful for visualizing the spinal cord itself, and can outline any blood clots, herniated discs, or other masses that may be impinging on the spinal cord.
If tests are negative, but the patient is still experiencing neck pain and is awake and alert, they may be sent home with a collar on, and will be re-examined in one to two weeks. At this time, x-rays will be repeated to ensure that no fracture or misalignment is present. Sometimes injuries are not immediately apparent if severe muscle spasm masks the injury.
|
