Nursing care of patients with Spinal cord injury and spinal cord contusion

Abstract

Introduction: Spinal cord injury is one of high risk healthcare problems and can develop the conditions that can be deliberating and even life - threatening. It is an abrupt injury that can cause severe physical and emotional damage, and undesirable life changing. Hence, nurses play a very critical role in monitoring and assessing patients’ motor and sensory functions, and transferring patients in a proper alignment to prevent any further complications. Nurses toned to have care planning and coordinate with medical and multidisciplinary units for home visit to prevent patents from any further complications and improve their quality of life.

Objective of study: To enhance skills in assessing patients to minimise complications and prepare patients and their families to attain the optimal level of functions according to professional standards.
Method: A case study of a patient who had a spinal cord injury and spinal cord bruises was admitted to the Orthopedic Department, Banmi hospital, from September to November 2020.
Case Description: A 53-year-old male was admitted to the hospital on September 1, 2021, at 7.05 p.m., from the Emergency Unit. The patient was injured in a drunk-driving accident, falling from a motorbike. His face hit the ground. He hadbruise over his left-sided face, a swollen left eye, weakness on both upper and lower extremities, motor power on upper extremities grade 2, motor power on lower extremities grade 1, a spinal shock, low blood pressure, and a slow pulse rate. The patient was treated for a spinal shock and carefully transferred to the unit. In the first admission, the patient was conscious, having weakness on both upper and lower extremities and breathing on his own. His vital signs were: temperature 36.5 C, pulse rate 96/ min, respiratory rate 20/ min, and blood pressure 105/60 mmHg. His motor and sensory system and respiratory system were evaluated. The result of the cervical spine MRI revealed. The exiting root compression of the right C6 and the C7. The patient developed hepatic encephalopathy with a rapid breathing respiratory rate of 24-26 / min. The patient was transferred to the intensive care unit and intubated according to an anaesthesiologist’s advice. The patient developed respiratory infection and his open airway was maintained. The patient was transferred to Naraimaharaj Hospital in Lopburi for spinal cord surgery. The physician gave supportive treatment and suggested a 1-month follow up. After the patient recovered from hepatic encephalopathy, he started rehabilitation, given 200 cc via nG tube feeding four times per day. The caretaker was taught NG tube feeding and sterile techniques for preventing nfection and how to put on a condom for the patient.  Physical therapy techniques were taught to the patient to improve muscle strength so that the patient could become physically and emotionally strong and get himself prespared for physical change Plan fordischarge: To ensure the house and environments were safe for the patient, the patient’s wife was suggested how to take care of the patient.His wife could give him lots of support, helping him move on and come to terms with his disability. Care planning was undertaken to reduce any further complications in a long term, and prevent infection, the case was transferred to the local clinic and hospitals nearby for home visit and given information of all supporting organizations available. The patient was also reminded about following up with the surgeon at Naraimaharaj Hospital. When the patient and the caretaker were ready, the patient was discharged from the hospital on September 20, 2021. The total length of stay in the hospital was 19 days.