Spinal Cord Injury: Signs & Symptoms

In this micro-lecture, we discuss the signs and symptoms of a spinal cord injury. Enrolled students have unlimited access to a rich library of learning materials such as this.

Today we’re going to talk about the signs and symptoms of a spinal cord injury using the Australian Resuscitation Council’s guidelines. Now, try and think about when you’re managing a patient who’s got some kind of trauma to the head, to the neck or the back. You have to try and remember that you have a very delicate set of nerves called the spinal cord that run down through the vertebrae of the spine.

Now, if the patient traps, compresses, severs or injures these very delicate tissues types, then you’re going to end up with a number of signs or symptoms, depending on the level at which they exit the spine basically.

Here we have a list of signs and symptoms of somebody with a spinal cord injury. Now remember that this is just a handful of signs or symptoms. You will always be able to read about more signs and symptoms in the journal articles, online and in textbooks.

And of course it’s really important you do have a good understanding of these when you’re trying to manage patients with potential spine injuries injuries. Let’s go with symptoms then. Let’s talk about the difference between a symptom and a sign.

A symptom is something the patient reports. Whereas, a sign is something that you can see for yourself. So symptom, pain in the injured region. So of course, the patient will be presenting in pain. Now, just remember that if a patient is presenting with the sort of mechanism of injury, then you can automatically suspect that that pain is caused by the particular mechanism.

What I mean by that is, sometimes, for example with a heart attack, a myocardial infarction, you end up with a chest pain that radiates and you think that it’s … If the pain is over here or down here, and really it’s your heart. So, use your knowledge of mechanisms of injury.

Pain in the injured region. So, let’s consider somebody has been hit by a car and their head has hit the concrete at quite a high speed. That patient may or may not be conscious and if they are, they’re going to be complaining of head pain and neck pain. Tingling, numbness in the limbs and area below the injury.

So, tingling and numbness in the limbs is something that patients will routinely complain of if there is a spinal cord injury below the injury. So, they’re complaining of these symptoms, tingling. And numbness means you can’t actually feel them. And that’s in the area below the injury.

Weakness or inability to move the limbs, paralysis. You can end up with both legs not being able to move. Maybe an arm and a leg. There’s different regions of the limbs that might be paralyzed. But the good news for paramedics in helping to diagnosis, is any paralysis is not a good sign. So it’s pretty straightforward.

So rather than trying to identify the exact nerve, you just know that paralysis is not a good sign. Nausea, headache or dizziness and altered or absent skin sensations. In other words, you can tap your patient and they are reporting that they can’t feel that. Usually you need to get them to close their eyes to do that.

And of course headache and dizziness. If you remember that your head is actually responsible for balance, inside the ears you’ve got the mechanisms for maintaining balance. So signs, things that you will see.

Head or neck in an abnormal position. Which can either be caused by the physical blow or by the position the patient has landed in. Signs of a head injury. Altered conscious state. So make sure you do that Glasgow Coma Scale early on. Breathing difficulty. So again, you need to … Going to need to have a look at the rate of breathing, the efforts of breathing. And also take a listen to the chest when it’s appropriate to do so. Signs of shock. So you’ll need to know your major signs of shock. And remember, there’s at least five classifications of shock. Including, cardiogenic, neurogenic, so on and so forth.

Changes in muscle tone. Either flacid or stiff. Remember that in your nervous system controls all of these things. Loss of function in the limbs. Loss of bladder or bowel control. Now, bladder, you’ll need to take a look at very carefully.

Maybe they’ve obviously urinated. Other times, you need to use the back of your hand to check. And of course priapism, particularly when people hang themselves and they’ve got a noose around their neck or some kind of inclusion to the upper nervous system. Okay guys, that’s a micro lecture on suspected spinal cord injury. Hope you’ve enjoyed the micro lecture and I look forward to speaking to you again shortly. Take care.

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