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Acute spinal cord injury (Management (Airway (Manual in line stabilisation…

- - - - A = complete loss of motor and sensory function
      - B-D = Incomplete loss of motor and sensory function (with decreasing severity)
      - E = Intact motor and sensory function
    - - Central cord syndrome = UL weakness with reduced pain and temp sensation and LL sparing (most common in cervical region, better prog for recovery)
      - Anterior spinal artery syndrome = sparing of the dorsal column, resulting in paralysis and dissociated sensory loss (reduced pain and temp sensation but preserved fine touch, vibration and proprioception)
      - Brown-Sequard Syndrome = ipsilateral motor loss (corticospinal tract), fine touch, vibration and proprioception (dorsal column) and contralateral loss of pain and temperature (spinothalamic tract)
- - - - Goal is to apply equal opposing forces to the head and neck, limiting cervical movement
      - Advantages over hard collar: reduces cervical mvmt better, improved laryngoscopc view by at least one grade (better mouth opening)
  - - - High cord-injured patients have better resp function when supine (daphragm has greater excursion in inspiration as it is pushed into the chest by the abdominal contents)
      - The flaccid intercostal muscles cause the chest wall to be drawn in rather than expand during inspiration (resp wean is later aided by the spasticity that develops in these muscles, reducing indrawing)
  - - - Maintain MAP> 85 for up to 5 days post injury to maintain spinal cord perfusion pressure (associated with better functional outcome)
      - Judicious use of IVT and vasopressors guided by invasive monitoring
      - Atropine for HD significant brady
  - - - Therapeutic hypothermia (limited human studies)
      - Steroids (not recommended by EMST)