"what is an acute spinal cord injury?"
The Acute Stage: the hours and days following a spinal cord injury
my loved one just suffered a spinal
what do i do?
Recognize that you are already doing what you need to do by seeking reliable and relevant information. The next hours and days are critical and can affect your loved one’s recovery. There are issues that must be addressed immediately and health concerns that many people aren’t even aware of until being thrust into the world of spinal cord injuries.
“WHAT ARE THE CHANCES OF SURVIVAL?”
Provided there aren’t any other life-threatening injuries, a person who has sustained a SCI will survive and also has almost the same life-expectancy as those who do not have SCIs. There are complications to be concerned about, but modern medicine can decrease or possibly prevent these complications from becoming life-threatening.
“We didn’t get a say in which hospital my loved one was brought to. How do I know if this hospital is equipped to handle a spinal cord injury?”
Provided there are no additional complications, the main goal of the emergency response team that arrived on the scene of the accident is to get the injured person to a Level I Trauma Center. A Level I Trauma Center is more than just an average emergency room. They meet criteria set forth by various governing agencies and typically house a trained trauma team, operating suite, imaging and laboratory facilities, trauma intensive care units, etc. 24 hours a day. They are able to handle the needs of both traumatically injured adult and pediatric patients.
“We are literally in the Emergency Room, what are the doctors doing to help my loved one?”
Emergency management of a spinal cord injury starts at the scene of the accident. Immediate actions are taken to establish an airway, ensure breathing and maintain circulation. Extra caution will be taken to immobilize the spine to prevent any further damage to the spinal cord. After stabilization, the injured person is transported quickly to the nearest Level I Trauma Center.
Once at, or even en route, to the hospital a high dose of the steroid Methylprednisolone is typically administered intravenously to reduce swelling around the spinal cord. This is extremely important because for this drug therapy to have an effect it must be given no less than eight hours after the injury.
Physicians will move forward with imaging tests, such as x-rays, MRIs or CT scans, and a neurological examination will be done to determine the level and extent of the spinal cord injury. The results from the exam will utilize the ASIA (American Spinal Injury Association of Spinal Cord Injury) scale and categorize the patient as ASIA A, B, C, D, or E with A being the most impaired and E the least.
The next step is to decompress the spinal cord. Depending on the type of injury this may involve one or a combination of surgery, traction and/or immobilization. Surgical intervention is sometimes needed to remove bone fragments or anything that may be compressing the spine. If vertebrae appear unstable a neurosurgeon may do a spinal fusion to provide permanent stabilization of two or more vertebrae.
“When the doctor comes out to speak to our family, what should I be asking?”
The trauma physicians often only have a few moments to spend with a family initially in order to continue treating your loved one. Knowing what you need to ask after finding out the immediate condition of your family member will ensure that time is used effectively.
• What level is the injury?
• Is there any sign of movement or feeling below the level of injury?
• Was Methylprednisolone given?
• What is going to be done to decompress the spinal cord? Surgery, traction, etc.?
“Is there a cure?”
Currently, there is no “cure.” However, many leading physicians and researchers in the spinal cord injury arena believe it will happen in our lifetime.
“Will my loved one recover?”
Recovery can be a tricky word. In the mind of a family asking this question for the first time recovery may mean your son or daughter, husband or wife, mom or dad receives treatment and leaves the hospital as they were before the injury. However, after only a little time spent in the world of SCI families quickly begin to understand a long road ahead to maximize recovery potential. Every injury is unique and therefore every recovery is, as well.
The key to recovery, above all, is never give up. Never give up hope that the cure will happen in our lifetime. Some type of recovery is inevitable and when science develops a cure the body that works hard will be able to accept it and continue the rigorous therapy required to one day walk again.
“How long will recovery take?”
Recovery is going to be an ongoing process. To combat the secondary conditions that accompany a SCI, an individual needs to be aggressive regarding the care and maintenance of their body post-injury.
Initially, however, the average person with an SCI is at an inpatient rehabilitation facility for anywhere from two to four months, depending on the type of injury and any other medical complications. Most patients are admitted to a rehabilitation facility an average of 28 days post-injury.
“What should I expect when I do finally get to see my loved one?”
Depending on the level of injury and whether or not other injuries occurred at the time of the SCI, there will be various medical equipment such as a tracheotomy connected to a ventilator for breathing assistance, catheters and foley bags for urine drainage, possibly a halo, neck brace or other form of spine stabilization apparatus, etc.
Whatever the case may be, the injured person is still there under all of that medical equipment and they will need you now more than ever. They are at the beginning of a very long physically, emotionally and mentally draining journey to regain their life and independence. Your love and support throughout may be the defining factor that determines whether the end result is a positive one. Remember, taking care of yourself will also allow you to take better care of your injured loved one.
“What do I do next?”
Get educated about everything SCI. Spinal cord injuries affect every facet of life: physical, emotional, financial, legal, etc. Staying informed and learning all you can will do a number of things. It will keep you from being surprised and caught off guard by situations that are bound to arise. It will give you back some control in the midst of the crisis. It will also ensure that you make informed decisions regarding the care of your loved one that could have potentially life-long effects.