Spinal Cord Injury Case Studies

The following paper will examine the etiology, mechanisms, and manifestations of spinal cord injuries, as well as how they relate to the case study. Given A.D.’s status, spinal shock can be suspected. Spinal shock is defined as “a sudden and complete transection of the spinal cord that results in complete loss of motor, sensory, reflex, and autonomic function below the level of injury,” and is often the immediate response to an acute spinal cord injury (Hung, 2009). After A.D. was ejected from his vehicle, he suffered a C5-C6 cervical subluxation (or misalignment), causing spinal cord damage. In the case of A.D., a severe drop in blood pressure was noted, dropping from 110/72 to 90/60, as well as a decreased heart rate, from 86 to 54 beats per minute. As damage to the spinal nerve tracts occur, system vasomotor tone is often loss, leading to vasodilation, and a decrease in the venous return rate (Hung, 2009). These factors decrease cardiac output, thus decreasing the blood pressure and heart rate (Young, 2010). A drop in the heart rate and blood pressure is known collectively as neurogenic shock (Hung, 2009). A decrease in cardiac
is already presenting many manifestations related to a severe spinal cord injury, there are other complications that can be anticipated as well. For example, skin breakdown can occur, due to the lack of mobility occurring during the injury (Hung, 2009). The nurses caring for A.D. need to be sure to move him often and use protective measures, such as skin prep, to prevent pressure ulcers from forming. The BRADEN scale should be utilized to further identify A.D.’s risk for impaired skin integrity (Ayello & Lyder, 2008). A.D. is also at a higher risk for developing edema or deep vein thrombosis (DVT) due to his injury, decreased vasomotor tone, and impaired mobility. To prevent these complications, compression stockings, binders, or other compression devices should be utilized to help increase the venous return (Hung,