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Please help to answer these questions This is the simulation with the patient have a problem...

Please help to answer these questions

This is the simulation with the patient have a problem with spinal cord injury. Please answer these question below base on this patient

1. Describe one intervention that positively affected the outcome of patient with spinal cord injury

2. Identify one safety hazard that occurred or could have occurred during patient with spinal cord injury

3. List the steps needed to stabilize a SCI and TBI patient

4. List the steps needed to stabilize the stroke patient

5. Identify one complication that is involved with the SCI and TBI patient

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Answer #1

Spinal cord injury is the damage to the spinal cord/spinal nerves which could impair the sensory or motor functioning. Many a times these injuries are traumatic as a result of direct impact or blow to the spinal cord.

1) One intervention that could positively affect the outcome of patient with spinal cord injury would be stabilisation of the patient. The patient needs to be positioned in a way that would reduce the impact of any movement of the affected site.

This would involve immobilising the entire spinal cord of the patient. The neck region can be immobilised using neck hard collar in a neutral position. The paramedics should be equipped to handle such cases. This is the preliminary measure needs to be taken to reduce further complication, but does not treat the initial affect of the injury. Depending the extent of the damage, various other surgical or therapeutic interventions needs to be administered.

2) A safety hazard that occurred or could occur during patient with spinal cord injury is loss of bladder and bowel control depending on the level at which the injury has occurred. Often times patient loss the control over the bowel and bladder control post the injury. Catheters are used in such cases. This might only be required for the short period of time as the patient learns to adapt with the new changes over time with rehabilitation.

3) A patient with SCI and TBI need to be stabilised which would involve monitoring the blood pressure, the heart rate, Breathing, temperature.

  • Blood Pressure- The patient may become hypotensive due to the posture. Pharmaceutical drugs such as nor adrenaline and fluid management can help keep the blood pressure in control
  • Heart Rate- Due to the damage to the endotracheal tube, the patient can easily develop Bradycardia. The heart rates should be continuously monitored for the same.
  • Skin- sensory functions need to be checked regularly as these patient are at the risk of losing sensory or motor functions. The skin should be checked regularly to see the development of bed sores as these patient remain in the same position over a long period of time.
  • Bladder and bowel functions- Early stage of the injury would require the use of Catheter. The patient can be rehabilitated for the long term.The bowel may be dysfunctional either because the bowel is relax but the anal sphincters aren't, which could lead to anal fissures if the sphincter muscles are not stimulated or if the bowel is flaccid while the anal sphincters reflex with no control. Diet should also be taken into consideration. A dietician needs to develop a meal plan involving adequate fibres for easy passage of the bowel.

SCI could require long term treatments involving surgeries and therapuetic rehabilitation.

4)Steps in management of a patient with Stroke-

The golden rule of managing a patient having a stroke s to get the patient to the hospital in the first one hour/ administering the required drug in the first 3 hours.

The very initial steps in stabilising the patient to check the Airway, Breathing and Circulation- ABC

CT, MRI and other imaging needs to be performed to identify the source of the problem. The flow of the blood to the brain needs to be restored using pharmacological drugs.

Blood pressure, heart rate, temperature need to be constantly monitored.

Once this is done, angioplasty or stints need to be placed surgically to ensure proper circulation and prevent the recurrence.

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