Nursing Intervention of Spinal Cord Injury

Definition of Spinal Cord Injury:

A spinal cord injury (SCI) is the damage to the spinal cord that causes changes in its function, either temporary or permanent. In this article I have presented nursing intervention or management of spinal cord injury.

Spinal cord injury management
Fig: Spinal cord injury management

 Nursing Intervention of Spinal Cord Injury:

Promoting adequate breathing and airway clearances-

  • Measure the vital capacity; monitor Oxygen saturation through pulse oxymetry and monitor ABG values.
  • Vigorous attention for clearing bronchial and pulmonary secretions.
  • Suctioning is indicated but it should be done cautiously because this may stimulate the vagus nerve and causes bradycardia.
  • If the patient cannot cough chest physiotherapy is given.
  • Proper humidification and hydration is essential to prevent secretions from becoming thick and difficult to remove.
  • Patient is assessed for signs of infection (eg: cough).
  • Smoking is discouraged because it increases bronchial and pulmonary secretions.

Improving mobility:

  • Proper body alignment is done all the time.
  • The patient is repositioned frequently and assisted out of the bed as soon as possible once the spinal cord is stabilized.
  • Feet are prone for foot drop so splints are used.
  • Contractures (A joint that is immobilized for a long time becomes fixed due to contractures) can be prevented by range of motion exercises.

Promoting adaptation to sensory and perceptual alterations:

  • The intact sense above the level of injury is stimulated through touch, aromas, flavorful beverages, conversation and music.
  • Provide prism glasses to enable the patient to see in supine position.
  • Encouraging use of hearing aids if indicated to enable the patient hear conversations and environmental sounds.
  • Provide emotional support to the patients.
  • Teach the patient to compensate for the losses.

Maintaining skin integrity:

  • Pressure ulcers will develop within 6 hours where there is continuous pressure and where there is continuous pressure and where peripheral circulation is inadequate. The most common sites includes is chialtuberoisity, The greater trochanter ,the sacrum, the occiput(back of the head).Patient who has cervical collar for prolonged periods of time develops breakdown from the pressure collars under chin, on shoulders and occiput.
  • Patient is turned every 2 hours to prevent pressure ulcers and pooling of blood and edema in dependent areas.
  • Careful inspection is made every time the patient is turned.
  • Skin over the pressure points is assessed for redness or breaking, perineum is checked for soiling and the catheter is checked.
  • Special attention is given to the areas which are in contact with the transfer board.
  • Patient’s skin should be kept clean by washing with mild soap.
  • Patient’s body alignment and posture should be assessed.
  • Pressure sensitive areas are lubricated and softened with hand crème or lotion.
  • Educate patient about the importance of providing skin care.

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