2.  Spinal cord carries nerve impulses from brain to body & back  Single injury can affect many organs & body functions

3.  Central › Brain & spinal cord  Peripheral › Nerves outside brain & spinal cord  Divisions › Voluntary › autonomic

4.  Principle support system for body  33 vertebra › Cervical-7 › Thoracic-12 › Lumbar-5 › Sacrum-5 › Coccyx-4

5.  Motor tracts  Carry impulses from brain to spinal cord to muscles  Pain tracts  Carry impulses from pain receptors to spinal cord then brain  Light touch tracts  Carry light touch impulses from sensory receptors to spinal cord to brain  Don’t assume that if a pt can’t feel light touch, that they can’t feel pain!!!

6. Most common: MVA Falls Gunshot wounds & recreational activities (football, diving). Pt still may have sensation & still have a spinal injury-affect vertebra not spinal cord Pt may also injure spinal cord, but not vertebra

7.  Compression › Wt of body driven into head  Flexion › Severe forward movement of head  Extension › Severe backward movement  Rotation › Lateral movement  Lateral bending › Body or neck bent severely from the side  Distraction › Vertebrae & spinal cord stretched & pulled apart (hangings)  Penetration › Foreign body impaled

8. Column Cord  More than one vertebrae  Bone injury  Usually painful  Dam  age to nervous tissue  Loss of sensory or motor function

9.  Area is completely transected  Total loss of sensory and motor function › Inability to move or feel sensations below level of injury › Likely have loss of bowel & bladder function › Pt may also be experiencing spinal shock

10.  Temporary “concussion” like insult to spinal cord  Usually occur high in cervical area  Loss of muscle tone, unable to feel light touch or pinch, paralysis, priapism  Risk for hypothermia due to temperature regulation affected  Usually resolves in 24 hours

11.  Interrupts nerve impulses to arteries  Arteries then dilate causing hypovolemia  S/S › Red skin › Skin dry › HR 60-80 › hypotension › Treat as other shock

12.  Cord injured but not through all 3 tracts  Will present with some confusing symptoms

13.  Central Cord syndrome › Weakness/paralysis › No pain in upper ext.  Anterior cord syndrome › Loss of pain sensation & motor function below injury  Brown-Sequard Syndrome › Injury to half of spinal cord › Will lose light touch, & motor function to one side, and pain to the other

14.  Likely MOI › Motorcycles crashes › MVA › Pedestrian-vehicle collisions › Falls › Blunt trauma › Penetrating trauma (head, neck, torso) › Sporting injuries › Hanging › Diving › Gunshot wounds (head, neck, chest, abdomen, back, pelvis) › Unresponsive trauma patient › Electrical injuries › Always maintain c-spine & fully immobilize

15.  General impression  Mental status  ABCs  Transport priorities

16.  Physical exam  Baseline vital signs  History  Signs and symptoms

17.  Take Standard Precautions  Establish manual in-line stabilization  Assess ABCs  Assess pulse, motor function, sensation  Assess the cervical region  Apply cervical spine immobilization collar  Immobilize patient to long backboard  Reassess pulse, motor function, sensation  Transport