Collaborative Care Immediate goal include: patent airway, adequate ventilation, adequate circulating blood volume, prevent extension of cord damage Initial care Ensure patent airway, stabilize cervical spine, administer oxygen, establish IV access, control external bleeding, Obtain imaging, prepare for stabilization with tongs and traction Ongoing monitoring VS, LOC, O2, sat, cardiac rhythm, urine output, keep warm, Monitor for urinary retention, hypertension, anticipate need for intubation if no gag reflux.Thoracic and Lumbar Vertebrae injuries Systemic support less intense, less respiratory compromise, no bradycardia, treat symptomatically Once stabilizes obtain history of incident, thorough assessment (muscle groups, sensory exam, associated brain injury, other injuries), Logroll, continuous monitoring.Surgical early indicated if evidence of cord compression, progressive neurologic deficit, compound fracture, bony fragments, penetrating wounds. Laminectomy. Drug therapy Vasopressor agents (maintain MAP >90) Altered drug metabolism leads to increased risk for interactions