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Spinal Cord
Injury
Management
Controversies in
#1
APKSMACCTalk
#2
ASIA Scale
#3
Spinal Shock
Neurogenic Shock
from acute spinal cord injury
loss of reflexes and flaccid paralysis
transient (days to months)
no specific treatment
haemodynamic phenomenon
due to sympathetic denervation
and unopposed vagal activity
fluids/pressors
#4
http://www.learnicu.org/Docs/Guidelines/CSCMAcuteManagementSpinal.pdf#5
http://journals.lww.com/neurosurgery/toc/2013/03002
ImageCredit:http://radiopaedia.org/
cases/ankylosing-spondylitis-with-
pseudoarthrosis
ImageCredit:HunchbackofNotre
Dame,1923,PublicDomain
#5
Occiput
Back
?
#7
#8
#9
Image Credit DOI: 10.4103/0970-9185.117053#10
1
2
3
ImageCredit:https://en.wikipedia.org/
wiki/Brain_herniation
Cerebral Perfusion
Pressure
#11
Spinal Cord
Perfusion
#12
ImageCredit:http://radiopaedia.org/
images/633886
#13
Episode 1: A New Hope?
The NASCIS Trilogy
#14
Episode 2: The steroids strike back
#15
Standard
of Care
Episode 3: Return of the steroids (oh please can we stop the
Star Wars theme now?...)
#16
2002 & 2012...
Oh no it’s worse than the Phantom Menace...
#17
Image Credit: Seth Anderson on Flickr,
https://secure.flickr.com/photos/
swanksalot/
Text Credit: Chris Nickson on LITFL,
http://lifeinthefastlane.com/education/
ccc/trauma-literature-summaries/#18
PMID 23417182
#19 image credit: http://antisteroid.wordpress.com
Kudos to Oli Flower and ICN Podcast #3
http://www.intensivecarenetwork.com/index.php/icn-
activities/icn-podcasts/144-podcast-3-the-acute-
management-of-spinal-cord-injury
#20
Thanks for watching

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SMACC 2014 PK spinal cord injury