ABC of spinal cord injury

Contents

1. At the accident:
• History and epidemiology of spinal cord injury
• Spinal injuries management at the scene of the accident
2. Evacuation and initial management at hospital:
• Evacuation and transfer to hospital of patients with spinal cord injuries
• Initial management of patients with spinal cord injuries at the receiving hospital
• Neurological assessment of patients with spinal cord injuries
• Spinal shock after severe spinal cord injury
• Partial spinal cord injury syndromes
3. Radiological investigations:
• Initial radiography of patients with spinal cord injuries
• Cervical injuries
• Thoracic and lumbar injuries
4. Early management and complications of spinal cord injuries — I:
• Respiratory complications
• Cardiovascular complications
• Prophylaxis against thromboembolism
• Initial bladder management
• The gastrointestinal tract
• Use of steroids and antibiotics
• The skin and pressure areas
• Care of the joints and limbs
• Later analgesia
• Trauma re-evaluation
5. Early management and complications of spinal cord injuries — II:
• The anatomy of spinal cord injury
• The spinal injury (cervical, thoracic and lumbar spine)
• Transfer to a spinal injuries unit
6. Medical management in the spinal injuries unit:
• The cervical spine injuries
• The cervicothoracic junction injuries
• Thoracic injuries
• Thoracolumbar and lumbar injuries
• Deep vein thrombosis and pulmonary embolism
• Autonomic dysreflexia
• Biochemical disturbances
• Para-articular heterotopic ossification
• Spasticity
• Contractures
• Pressure sores
7. Urological management of patients with spinal cord injury:
   • Early management
   • Investigations and urological review
   • Later management
   • Detrusor hyperreflexia
   • Stress incontinence
   • The acontractile bladder and assisted voiding
   • Mixed faecal and urinary incontinence
8. Nursing for people with spinal cord lesion:
• Nursing management
• Nursing intervention
9. Physiotherapy after spinal cord injury:
• Respiratory management
• Mobilisation into a wheelchair
• Rehabilitation
• Recreation
• Incomplete lesions
• Children
10. Occupational therapy after spinal cord injury:
• Hand and upper limb management
• Home resettlement
• Activities of daily living
• Communication
• Mobility
• Leisure
• Work
11. Social needs of patient and family:
• Changed relationships
• Finance
• Adapting homes
12. Transfer of care from hospital to community:
• Education of patients
• Teaching the family and community staff
• Preparation for discharge from hospital
• Easing transfer from hospital to community
• Travel and holidays
• Follow-up
13. Later management and complications after spinal cord injury — I:
• Late spinal instability and spinal deformity
• Pathological fractures
• Post-traumatic syringomyelia (syrinx, cystic myelopathy)
• Pain
• Sexual function
14. Later management and complications after spinal cord injury — II:
• Later respiratory management of high tetraplegia
• Psychological factors
• The hand in tetraplegia
• Functional electrical stimulation
• Ageing with spinal cord injury
• Prognosis
15. Spinal cord injury in the developing world:
    • Introduction
    • Incidence of spinal cord injury
    • Financial considerations
    • Manpower and staffing issues
    • Social, psychological and architectural barriers
    • Providing for the needs of spinal cord injured patients in developing countries
    • Conclusions