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Spinal injury: assessment and initial management
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Approximately 1000 people sustain a new spinal cord injury (SCI) each year in the UK. These injuries are associated with serious neurological damage, and can result in paraplegia, quadriplegia or death. Currently there are no ‘cures’ for SCI and in the UK there are 40,000 people living with long term disabilities as a result of such injuries.
Care of an acutely spinally injured patient is aimed towards the preservation of function and prevention of disability. Whilst primary prevention of SCI is not within the scope of this guideline, the avoidance of secondary injury, both mechanical and physiological, is crucial in limiting the effects of acute SCI.
Spinal injuries do not always occur in isolation and the acute management of the patient with multiple injuries is covered in the NICE clinical guideline on major trauma and will be cross referred to when appropriate.
This guideline addresses both cord and column injury. While approximately 15% of people with a spinal column fracture or dislocation will have a cord injury, the majority of people with a cord injury will have an accompanying column injury. Of particular importance is the avoidance of secondary SCI in the presence of an unstable spinal column. Avoidance of a cord injury mandates an awareness of the possibility of column injury and resultant protection of the spinal cord from the time of injury. This requires a standardised and effective approach for spinal immobilisation in both the pre-hospital and hospital phases.
National Institute for Health and Care Excellence - Organizational Body
NONE
Healthcare Management
English
February 2016
1-247
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