Spinal Cord Injury Medicine. 2. Acute Care Management of Traumatic and Nontraumatic Injury


      Wuermser LA, Ho CH, Chiodo AE, Priebe MM, Kirshblum SC, Scelza WM. Spinal cord injury medicine. 2. Acute care management of traumatic and nontraumatic injury.
      This self-directed learning module highlights the basic acute care management of traumatic and nontraumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Acute traumatic SCI is optimally managed in a level 1 trauma center. Decompression of the neural elements, stabilization of the spine, and maintenance of tissue perfusion are fundamental to optimizing outcomes. SCI patients are at high risk of pressure ulcers, venous thromboembolism, stress ulceration, bowel impaction, dysphagia, and pulmonary complications. Physiatric interventions are needed to prevent these complications. Prognostication of neurologic outcome based on early examination is an important skill to aid in creating a rehabilitation plan and to test for efficacy of early interventions. Nontraumatic SCI is an increasing population in rehabilitation centers. Establishing a diagnosis and treatment plan is essential, in conjunction with prevention of complications and early physiatric intervention.

      Overall Article Objectives

      (a) To describe the diagnostic evaluation of traumatic and nontraumatic spinal cord injuries and (b) to summarize the medical, surgical, and physiatric interventions during acute hospitalization for these injuries.

      Key Words

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      Linked Article

      • Corrections
        Archives of Physical Medicine and RehabilitationVol. 88Issue 8
        • Preview
          The following corrections concern reference 2 in Wuermser LA, Ho CH, Chiodo AE, Priebe MM, Kirshblum SC, Scelza WM. Spinal cord injury medicine. 2. Acute care management of traumatic and nontraumatic injury. Arch Phys Med Rehabil 2007;88(3 Suppl 1):S55-61.
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      • Consortium for Spinal Cord Medicine
        Archives of Physical Medicine and RehabilitationVol. 88Issue 8
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          We were stunned to discover that an article1 in the March 2007 supplement includes a key reference identified as a publication by the Consortium for Spinal Cord Medicine (CSCM) entitled Early Acute Management in Adults With Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Providers published in 2007 by Paralyzed Veterans of America. Simply stated, this reference does not exist. A document by this title is presently in draft format only. This draft document is confidential and has not been through field review, legal review, or approved for publication by the CSCM’s Steering Committee.
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