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- What is spinal shock? How long can it last? Why is it difficult to determine the degree of injury and impairment during this time frame?
According to Boland et al. (2011), spinal shock refers to an immediate response to cord transection. This condition arises as a result of spinal injury. This condition of spinal shock can last up to 6 weeks. It is difficult to determine the degree of injury since the state differs depending on the severity and spinal cord injury location. The range of movement is affected as the motor operation is an impasse. Damages of the thoracic segment produce paraplegia, which affects the spinal.
- Immediately after this injury, what should you expect to occur for each of the following: 1. Range of movement for his arms? For his legs? Why? 2. Spastic or flaccid paralysis? Why?
After spinal cord injury, shock develops that is manifested by flaccid paralysis as this is a loss of a reflex.
- Bowel and bladder dysfunction? Why or why not?
The patient suffering from spinal shock experiences a loss of bowel and bladder dysfunction since the nerves controlling these internal organs attached to the spinal cord base are not getting impulses from the brains since this is sensory loss (Conti et al. 2020).
- Breathing difficulties? Why or why not?
Patients with spinal shock manifest breathing difficulties evidenced by low lung volumes, spontaneous ventilation, and weak cough since spinal cord injury severely comprises both sensory and motor functions, leading to an interruption of the descending bulbospinal respiratory pathways resulting in respiratory muscle passes.
- After the period of spinal shock, what changes should you expect to see (if any) in the manifestations listed in #2 above?
Indications which spinal shock is resolving includes;
- Return of bubo cavernous reflex.
- Return of reflexes.
- Return of Babinski’s reflex.
- Development of hyperreflexia rather than placidity.
- Return of reflex emptying the bladder.
- What type of rehabilitative treatments might G. H. need to promote his recovery and return to function?
G.H. should go for rehabilitation. It should promote mobility use of wheelchairs, thoracolumbar sacral braces to make muscle strong. Boost bladder and bowel function, which includes treatment to reduce urinary complication and use of bethanechol to stimulate bladder contraction (Roberts et al. 2017).
- If G. H. has mild-to-moderate chronic back pain one year after his accident, explain the pain management medications, you would suggest improving his quality of life and why you selected those particular medications.
Reduce breathing problems; it’s essential to educate the patient to use incentive spirometry, diaphragmatic breathing to enable vital capacity. Glossopharyngeal breathing forces air into the lungs by the rising tongue and muscles of the pharynx. Prevent pressure ulcers by positioning them frequently. The patient should be taking a sufficient diet fiber, and fluid intake is essential.
References
Boland, R. A., Lin, C. S. Y., Engel, S., & Kiernan, M. C. (2011). Adaptation of motor function after spinal cord injury: novel insights into spinal shock. Brain, 134(2), 495-505.
Conti, K., Yellapu, V., Sweeney, J., Falowski, S. M., & Stawicki, S. P. (2020). Spinal Shock: Differentiation from Neurogenic Shock and Key Management Approaches. Clinical Management of Shock: The Science and Art of Physiological Restoration, 109.
Roberts, T. T., Leonard, G. R., & Cepela, D. J. (2017). Classifications in brief: American spinal injury association (ASIA) impairment scale.