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SAFE TRANSPOTATION OF PATIENT WITH SPINAL INJURYThe Spinal Cord is connected to the brain and is about the diameter of a human finger. From the brain it descends down the middle of the back and is surrounded and protected by the bony vertebral column. The spinal cord is surrounded by a clear fluid called Cerebral Spinal Fluid (CSF), that acts as a cushion to protect the delicate nerve tissues against damage from banging against the inside of the vertebrae.

SPINAL CORDIt consists of millions of nerve fibres which transmit electrical information to and from the limbs, trunk and organs of the body, back to and from the brain. The nerves which exit the spinal cord in the upper section, the neck, control breathing and the arms. The nerves which exit the spinal cord in the mid and lower section of the back, control the trunk and legs, as well as bladder, bowel and sexual function.

The nerves which carry information from the brain to muscles are called Motor Neurones. The nerves which carry information from the body back to the brain are called Sensory Neurones. (Sensory Neurones carry information to the brain about skin temperature, touch, pain and joint position).

The brain and spinal cord are referred to as the Central Nervous SystemThe nerves connecting the spinal cord to the body are referred to as the Peripheral Nervous System.The lower end of your spinal cord stops a little above your waist in the region called the conus medullaris. Below this region is a group of nerve roots called the cauda equina.ASCENDING AND DESCENDING SPINAL TRACTSThe nerves within the spinal cord are grouped together in different bundles called Ascending and Descending tracts. Ascending tracts: the spinal cord carry sensory information from the body, upwards to the brain (such as touch, skin temperature, pain and joint position).Descending tracts:the spinal cord carry information from the brain downwards to initiate movement and control body functions.

Spinal Nerves

Nerves called the spinal nerves or nerve roots, branch off the spinal cord and pass out through a hole in each of the vertebrae called the Foramen. These nerves carry information from the spinal cord to the rest of the body, and from the body back up to the brain.There are four main groups of spinal nerves, which exit different levels of the spinal cord. Cervical Nerves "C" : (nerves in the neck) supply movement and feeling to the arms, neck and upper trunk. Also control breathing.Thoracic Nerves "T" : (nerves in the upper back) supply the trunk and abdomen.Lumbar Nerves "L" and Sacral Nerves "S" : (nerves in the lower back) supply the legs, the bladder, bowel and sexual organs.

SPINAL CORD INJURYDEFINITIONA spinal cord injury damage to any part of the spinal cord or nerves at the end of the spinal canal often causes permanent changes in strength, sensation and other body functions below the site of the injury.CAUSESMotor vehicle accidents. Auto and motorcycle accidents are the leading cause of spinal cord injuries, (accounting for more than 40 percent of new spinal cord injuries each year)Falls. Spinal cord injury after age 65 is most often caused by a fall.Acts of violence. As many as 15 percent of spinal cord injuries result from violent encounters, often involving gunshot and knife wounds.(according to the National Institute of Neurological Disorders and Stroke)

Sports and recreation injuries. Athletic activities, such as impact sports and diving in shallow water(causes 8 percent of spinal cord injuries). Alcohol. Alcohol use is a factor (1 out of every 4 spinal cord injuries). Diseases. Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal cord injuries

TYPESComplete. If almost all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete. Incomplete. If you have some motor or sensory function below the affected area, your injury is called incomplete. There are varying degrees of incomplete injury. Additionally, paralysis from a spinal cord injury :Tetraplegia or quadriplegia. This means your arms, hands, trunk, legs and pelvic organs are all affected by your spinal cord injury. Paraplegia. This paralysis affects all or part of the trunk, legs and pelvic organs.

SIGNS AND SYMPTOMSLoss of movement Loss of sensation( including the ability to feel heat, cold and touch )Loss of bowel or bladder control Exaggerated reflex activities or spasms Changes in sexual function, sexual sensitivity and fertility Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord Difficulty breathing, coughing or clearing secretions from your lungs

EMERGENCY SIGNS AND SYMPTOMS

Extreme back pain or pressure in your neck, head or back Weakness, incoordination or paralysis in any part of your body Numbness, tingling or loss of sensation in your hands, fingers, feet or toes Loss of bladder or bowel control Difficulty with balance and walking Impaired breathing after injury An oddly positioned or twisted neck or back

FIRST AID MEASURESDon't move the injured person permanent paralysis and other serious complications may result. Call local emergency medical assistance number. Keep the person still. Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving, until emergency care arrives. stopping any bleeding and making the person comfortable, without moving the head or neck

Transfer patient to spine boardThere are four standard methods described for transferring an injured individual onto a stretcher or spine board from the supine position: log roll.straddle lift and slide.6 + lift and slide.The scoop stretcher.LOG ROLL METHODA minimum of four rescuers is required : One rescuer maintains manual inline stabilization of the headanother one is responsible for positioning the spine board.Two people are positioned on the same side of the patient to perform the roll. During the roll, the patient is rotated axially to an angle of approximately 3090, (the spine board is placed at an angle beneath the patient). After the spine board is in place, the patient and the board are rolled back to the ground. Finally, the team must center the patient on the spine board in the supine position.

Prone log roll push maneuver for transferring a prone patient to a spine board

STRADDLE LIFT AND SLIDE

Five rescuers are required :One rescuer maintains manual inline stabilization of the head.Another one is responsible for positioning the spine board. The three other rescuers straddle the body at the level of the chest, pelvis, and lower extremities to perform the lift. Once the patient is lifted 1020 cm off the ground, the board is slid beneath the patient, from the feet toward the head. The patient is then carefully lowered onto the board.

6 + LIFT AND SLIDEEight rescuers are required: One rescuer maintains manual inline stabilization of the head.Another one is responsible for positioning the spine board. Six additional rescuers are placed in pairs across from one another at the chest, pelvis, and lower extremities to perform the lift. Once the patient is lifted 1020 cm off the ground, the board is slid beneath the patient from the feet toward the head. The patient is then carefully lowered onto the board.

SCOOP STRETCHER

Four rescuers are required :One rescuer maintains manual inline stabilization of the head. Three rescuers position and secure the scoop stretcher@ two are located at shoulder level on either side of the patient & third one is located at the feet. The two longitudinal halves of the scoop stretcher are separated and then positioned on either side of the patient. Each half of the scoop stretcher is carefully wedged beneath the patient until both ends are securely locked into place.

PREVENTIONDrive safely: Car crashes are one of the most common causes of spinal cord injuries. Wear a seat belt every time you drive or ride in a car. Make sure that your children wear a seat belt or use an age and weight appropriate child safety seat. To protect them from air bag injuries, children under age 12 should always ride in the back seat.

Check water depth before diving: To make sure you don't dive into shallow water, don't dive into a pool unless it's 9 feet or deeper, don't dive into an above ground pool, and don't dive into any water of which you don't know the depth.Prevent falls:Use a step stool with a grab bar to reach objects in high places. Add handrails along stairways. Put nonslip mats on tile floors. For young children, use safety gates to block stairs and consider installing window guards.

Take precautions when playing sports. Always wear recommended safety gear. Avoid leading with your head in sports. For example, don't slide headfirst in baseball, and don't tackle using the top of your helmet in football. Use a spotter for new moves in gymnastics.

Don't drink and drive. Don't drive while intoxicated or under the influence of drugs. Don't ride with a driver who's been drinking

IMPORTANT THING

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