Clearing the Cervical Spine in the Unconscious Patient in the Intensive Care Unit

2017 ◽  
pp. 322-328
Author(s):  
Michael Athanassacopoulos ◽  
Neil Chiverton
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cervical Spine ◽  
The Unconscious ◽  
Unconscious Patient

scholarly journals Outcome of Cervical Spine Trauma Patients Admitted to the Intensive Care Unit at a Tertiary Government Referral Trauma Center in Nepal

2021 ◽  
pp. 219256822098070
Author(s):  
Gyanendra Shah ◽  
Gaurav Raj Dhakal ◽  
Anil Gupta ◽  
Pawan Kumar Hamal ◽  
Siddhartha Dhungana ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Limited Resource ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Resource Setting ◽  
Cord Injury ◽  
Huge Impact

Study Design: Retrospective study. Objectives: Cervical spinal cord injury (SCI) is a devastating event for patient and family. It has a huge impact on society because of intensive resources required to manage the patient in both acute and rehabilitation phases. With the limited resource setting in underdeveloped countries like Nepal, questions are often raised regarding whether the outcome justifies the expenses of their care. The objective was to assess the outcomes of cervical SCI patients admitted to intensive care unit (ICU). Methods: All cervical SCI admitted in ICU during May 2017 to August 2018 were included in this study. Demographic details, mode, morphology, and neurological level of injury, intervention performed and outcomes of ICU stay were analyzed. Results: Out of 48 patients, 36 (75%) were male and 12 female with mean age 43.9 ± 15.9 years. Fall injury was the commonest mode of injury (83.3%). Most patients presented within 1 to 3 days of injury and C5-C6 (33.3%) was the most common involved level and 75% presented with ASIA A neurology. Mechanical ventilation was required in 95.8% of the patients and 22 patients were operated upon. The average stay in ICU was 15 days and 13 patients died in the ICU. Conclusions: Majority of cervical SCI with complete motor paraplegia required ICU care. Inspite of the intensive care, a subset of these patients succumbed to the complications of the injury. Therefore, it is essential to establish trauma ICU care with specific protocols on managing cervical spine injuries.

Management of unconsciousness in the ICU

2016 ◽  
Author(s):  
Joshua Kornbluth ◽  
Robert D. Stevens
Keyword(s):  
Critical Care ◽  
Cervical Spine ◽  
Supportive Care ◽  
Cervical Spine Injury ◽  
Diagnosis And Treatment ◽  
Spine Injury ◽  
The Unconscious ◽  
Unconscious Patient ◽  
Ultimate Cause ◽  
Underlying Pathophysiology

The key to the treatment of unconsciousness is an understanding of the underlying pathophysiology. Management of the unconscious patient should be targeted towards the diagnosis and treatment of the cause combined with supportive care of the patient, while the ultimate cause is elucidated. The basic tenants of emergency and critical care medicine—the ABC’s—apply to the unconscious patient with particular care if occult cervical spine injury is a possibility. The prognosis of disorders of consciousness depends heavily on the aetiology and accurate prognostication can be difficult even when the underlying cause has been determined.

scholarly journals Nursing pain assessment in non verbal intensive care patient

2018 ◽  
Vol 4 (4) ◽  
pp. 186
Author(s):  
Anastasia Villioti ◽  
Antonia Kalogianni ◽  
Dimitrios Papageorgiou ◽  
Edison Jahaj
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Assessment ◽  
English Language ◽  
Care Patient ◽  
Assessment Tools ◽  
Publication Date ◽  
Nursing Interventions ◽  
The Unconscious ◽  
Experienced Nurses

Introduction:  It has been found out that pain is one of the most important issues that patients have to deal with while they are hospitalized in an intensive care unit (ICU), especially when they are non-communicative. Nurses play the most important role in the pain assessment through the everyday contact with patients and with the use of a variety of pain assessment tools as well.Aim:  The purpose was to determine nurses’ level of knowledge about the use of pain assessment tools (especially pain scales) in the unconscious intensive care patients – To investigate the level of pain assessment tools application in the daily nursing routine by the ICU nurses.Material and Method: A systematic review in the followed database was applied: Pubmed-Medline-Embase. The entry criteria in the review were: a) Publication date: 1990-2017 b) Greek or English language c) the sample of research must necessarily include experienced nurses who work exclusively in an intensive care unit. d) the use of pain assessment tools for non verbal patients should be included in the nursing interventions e) nurses should be responsible for the daily care of non verbal patients f) the results must be concern exclusively non communicative patients.Results: From the research four studies have emerged which met the standards of the review. The common findings among these researches result in the fact that although nurses believe that an effective pain assessment is important to a great extent, very few of them use pain assessment tools according to protocols especially in the unconscious patients.Conclusions:  Nursing pain assessment concerning non verbal patients still remain inadequate and doesn’t seem to be a priority during the daily nursing routine. The promotion of education of nurses concerning pain assessment is required and the use of protocols as well in order to ease the process of a reliable and valid pain assessment.

scholarly journals Persistent Hypertensive Response Following Dexmedetomidine Infusion in a Patient with Cervical Spinal Cord Injury

2018 ◽  
Vol 09 (03) ◽  
pp. 426-427 ◽  
Author(s):  
Siddharth Chavali ◽  
Shalendra Singh ◽  
Ashutosh Kaushal ◽  
Ankur Khandelwal ◽  
Hirok Roy
Keyword(s):  
Intensive Care Unit ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intensive Care ◽  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Dexmedetomidine Infusion

ABSTRACTWe report a 19-year-old male patient, an operated case of anterior cervical discectomy and fusion for traumatic C5–C6 vertebral injury, who developed persistent hypertension following dexmedetomidine infusion in the Intensive Care Unit to enable tolerance of noninvasive ventilation mask. This unusual side effect should be borne in mind when using this drug in patients with cervical spine injuries.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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