Specialty Focused Recordings: Spine-305 Navigating The New Spinal Cord Injury Guidelines

Video Transcription

Video Summary

Charlotte Davis reviews the 2022 American College of Surgeons spinal cord injury guidelines and their evidence-based recommendations. Prehospital care should emphasize spinal motion restriction rather than rigid immobilization, with trained teams using a six-person lift. Helical CT is preferred over plain X-rays for spinal injuries; MRI is needed to assess spinal cord damage, and whole-body CT can help identify life-threatening injuries in polytrauma patients. C-collars should be cleared and removed as early as safely possible.<br /><br />For acute spinal cord injury, the guidelines recommend maintaining a MAP of 85–90 for at least seven days, starting venous thromboembolism prophylaxis within 72 hours, and beginning bowel/bladder management and rehabilitation early. Physical and occupational therapy should start in the first week, even when patients receive sedation or vasoactive medications. Steroids are not recommended for penetrating injuries, and evidence for other drug prevention remains insufficient.<br /><br />Davis urges involving bedside nurses in implementing guideline changes and educating care teams.

Keywords

spinal cord injury

American College of Surgeons guidelines

prehospital spinal motion restriction

helical CT imaging

MAP 85-90 management

early rehabilitation nursing