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Spinal Shock
- occurs immediately in response to injury
- flaccid paralysis
- loss of activity below injury
- usually lasts 24 hours but can go on for weeks
- muscle spasticity with cervical or high thoracic injuries
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Spinal Shock Motor-Cardiovascular & Respiratory Assessment
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CV imapired w/injury above 6th thoracic vertabrae
- dysrhythmia
- systolic blood pressure <90
- hypothermia
- increased risk for resp function
- atelactasis
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Spinal Shock-other assessments
- hyper DTR in lower motor neurons
- hypo DTR in upper motor neurons
- pressure points lead to skin breakdown
- bony growth into muscle -> decreased ROM
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Spinal Shock-non surgical management
- assess constantly
- ck for neurogenic shock w/in 1st 24 hours
- spinal shock w/bradycardia
- decreased or absent blowl sounds
- warm, dry skin
- hypothermia
- hypotension
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Spinal Shock-surgical management
- halo to realign vertebrae and aid healing
- skeletal traction
- stryker frame, rotational bed
- corset or brace when mobile to keep spine aligned
- full body cast
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Spinal Shock-drug therapy
- methylprednisolone
- dextran (plasma expander)
- atropine (bradycardia)
- domanine (vasopressor)
- tizanidine (muscle relaxer)
- baclofen (muscle relaxer)
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Spinal Shock-surgical management
- emergency surgery for decompression
- decompressive laminectomy
- spinal fusion
- Harrington rods to stabilize thoracic spinal injuries
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Spinal Shock-interventions
- for ineffective breathing:
- clear airway
- assist w/coughing
- incentive spirometer
- trachea suctioning
- for self care deficit:
- pressure ulcers, dvt's or pulmonary emboli
- positioning, ROM, ted hose, heparin
- prevent orthostatic hypotension
- promote self care
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