Full Description
Despite significant improvements in prehospital, critical care and surgical management, traumatic spinal cord injury is still a major cause of disability with devastating physical, social and psychological consequences, leading to significant direct and indirect health care costs. Taking a practical approach, this book addresses all aspects of traumatic spinal cord injury, from the pre-hospital setting to discharge. Furthermore, the book highlights the central role of trauma networks and neurocritical care specialisation.Encouraging a protocol-driven, multidisciplinary approach, the authors provide a methodological description of the diagnostic and therapeutic management of patients with traumatic spinal cord injury throughout the patient's entire course.
Neurological injuries and their sequelae assume predominant significance in this type of patient. Patients with traumatic spinal cord injury may suffer from both acute injuries and long-term dysfunctions affecting different types of organs and apparatuses. Bradyarrhythmia, haemodynamic instability, hypothermia, hyperthermia, pain, spasticity and autonomic dysreflexia are just a few examples of the possible debilitating conditions that our patients may suffer from and that, consequently, the clinician must address. Consequently, a multidisciplinary approach is required to provide appropriate clinical management.
Paying particular attention to prognosis and the implementation of an early neurorehabilitation programme, the authors examine the challenges of living with spinal cord injury for both patients and families.
Contents
1. Epidemiology and socioeconomic impact of traumatic spinal cord injury.- 2. Mechanisms and pathophysiology of spinal cord injury.- 3. Prehospital evaluation and management, Part I: clinical presentation, spine stabilization, airway management..- 4. Prehospital evaluation and management, Part II: fluid and blood pressure management, assessment of hemostasis and correction of coagulopathy..- 5. The role of trauma networks and neurocritical care specialization in the treatment of spinal cord injury.- 6. Spinal cord injury syndromes and classification .- 7. Neuroradiological imaging: techniques and prognostication .- 8. Principles and timing of surgical management .- 9. Anesthesia considerations and intraoperative monitoring .- 10. Pharmacotherapy .- 11. Special populations: elderly, pregnant, pediatric, and polytrauma patients.- 12. Hemodynamic management and cardiovascular complications .- 13. Respiratory Complications and the Role of the Respiratory Therapist: Noninvasive and Invasive Ventilation.- 14. Mechanical ventilation management, indications and Timing of Tracheotomy and the Role of Diaphragmatic Pacing Stimulation in Spinal Cord Injury.- 15. Hematological and endocrine complications after traumatic spinal cord injury.- 16. Gastrointestinal and genitourinary dysfunction: acute and long-term management.- 17. Infectious complications.- 18. Metabolism, nutrition, and muscle wasting in critically ill spinal cord injury patients .- 19. Autonomic dysreflexia, postural hypotension, pain and spasticity, and altered temperature homeostasis.- 20. Neural repair and regeneration after spinal cord injury .- 21. Prognostication, long-term functional trajectories, and psychological support for patients and families.- 22. Current and future role of neurorehabilitation and challenges of living with spinal cord injury.
