Spinal Injuries

DEVELOPMENT CLASS

SPINAL INJURIES

 

 

THE SPINAL CORD

 

The spinal cord is contained in a narrow channel within the vertebrae and so any injury to the spine may easily affect the cord. The cord carries impulses or messages between the brain and muscles and organs all over the body.  The spinal cord has poor self-healing powers, so injuries to it cannot always be corrected by surgery. The higher up the spinal cord the injury, the more of the body is affected. Spinal injuries can result in death, or permanent paralysis, so proper recognition, immobilisation and management of the patient may mean the difference between complete recovery and lifelong paralysis, or even death.

 

SPINAL INJURIES

 

TYPES OF INJURY

 

Types of injury may include:

 

·        Dislocation of the vertebrae

·        Fractures of the vertebrae

·        Displaced intervertebral discs

 

They may or may not involve damage to or compression of the spinal cord. Initially it may be impossible to determine spinal cord involvement, always assume that there is.

 

 

MECHANISM OF INJURY

 

Spinal injuries are caused by direct or indirect force or violence and should always be suspected in all cases where:

 

·        where there is a history of accident or injury to the vertebral column.

·        casualty complains of pain in back or neck.

·        where there has been hyperflexion or whiplash injuries of the neck.

·        heavy weight has landed on the casualty’s shoulders

·        a fall from a height and landing on the heels has occurred

·        acceleration/deceleration strains placed on the neck

·        unconscious patient been involved in a road traffic accident.

 

REMEMBER

Regard all these cases as serious and treat as a fracture

 

The mechanism of injury alone may suggest that a spinal injury exists.

 

 

 

SPINAL INJURIES

SIGNS AND SYMPTOMS OF INJURIES TO THE SPINE

 

·        loss of feeling or sensation in the body below the site of injury

·        tingling, or ‘pins and needles’ above the site of injury

·        paralysis below the site of injury often accompanied by loss of internal muscle control which causes incontinence.

·        Displacement of a spinal vertebrae felt as an unnatural lump, or depression, from the normal continuity of the spinal column.

·        fixation of the spinal column at the site of the injury.

 

MANAGEMENT OF SPINAL INJURIES

 

·        Ensuring a open airway (by jaw thrust), and maintaining a neutral alignment position

·        Supporting the head and neck and applying a cervical collar

·        Carry out a secondary survey to establish the site of injury

·        Handling slowly and carefully avoiding any jarring or rotation of the head and lower limbs.

·        Avoiding rotation and angulation of the spine

·        Immobilising the lower limbs at the knees and ankles

·        Secure upper limbs to prevent movement

·        Place carefully onto a spinal board

·        Administer high concentration of oxygen (Neurogenic Shock)

·        Use orthopaedic stretcher to lift patient

·        Avoid all unnecessary movement of the patient

·        Positioning the patient with adequate spinal support

·        Transport the patient slowly and smoothly taking into account adverse road conditions.