Question

Please help answer this question

Can you describe the step by step process that should be applied to a patient experiencing spinal or neurogenic shock and potential TBI?

Answer 1

Spinal shock arises due to injury of spinal cord followed by loss of motor nd sensory function below the level of injury.

Neurogenic shock arises due to hemodynamic changes associated with a loss of autonomic tone at the level of injury of spinal cord.

In any of the above case, we need to take utmost care to prevent further injury to the cord. This is done by giving a C pillar and a spinl back board to immobiluze the patient.

ABC support to be given. Intubation of supplemental oxygen supply is required. Breathing support need to be restored after complete assessment.

In both the cases Hypotension bradycardia hypothermia will be present. First we need to suplly IV line and fluid need to be supplied. but if still hypothermia exists we need to try pressors. Bradycardia can be managed by giving Atropine. Hypothermia can be managed by thermal support.

TBI:

If the patient is found to have Traumatic brain injury Glasgow coma scale to be performed. CT scan , MRI scan need to be performed. Dr need to ask the entire incident or history. other injury need to be taken care.

Treatment includes to restore ABC Vasopressors, seizure preventing drugs, coma inducing drugs.

Treatment: For mild injury to take rest. For moderate to severe injuries surgery need to be done to prevent the blood clot , fixing skul fractures, skull window to reduce the intracranial pressure, etc. Later occupational therapy, physiotherapy, speech therapy, etc to be given