How to man­age spinal cord in­jury?

My dad suf­fered spinal cord in­jury three months ago and he is bedrid­den now. Please share use­ful in­for­ma­tion on how to man­age the con­di­tion. Habashiya L.

Daily Trust - - HEALTH - health­in­ter­ac­tive@hot­ DR AMINU MA­GASHI

Ac­cord­ing to the World Health Or­gan­i­sa­tion (WHO), the term ‘spinal cord in­jury’ refers to the “dam­age to the spinal cord re­sult­ing from trauma (e.g. a car crash) or from dis­ease or de­gen­er­a­tion (e.g. cancer).

Symp­toms of spinal cord in­jury de­pend on the sever­ity of in­jury and its lo­ca­tion on the spinal cord. Symp­toms may in­clude par­tial or com­plete loss of sen­sory func­tion or mo­tor con­trol of arms, legs and/or body. The most se­vere spinal cord in­jury af­fects the sys­tems that reg­u­late bowel or blad­der con­trol, breath­ing, heart rate and blood pres­sure. Most peo­ple with spinal cord in­jury ex­pe­ri­ence chronic pain.”

• Trans­fer method to hos­pi­tal af­ter in­jury and time to hos­pi­tal ad­mis­sion are im­por­tant fac­tors. Pre­ventable sec­ondary con­di­tions (e.g. in­fec­tions from un­treated pres­sure ul­cers) are no longer among the lead­ing causes of death of peo­ple with spinal cord in­jury in high-in­come coun­tries, but th­ese con­di­tions re­main the main causes of death of peo­ple with spinal cord in­jury in low-in­come coun­tries.

• Spinal cord in­jury is as­so­ci­ated with a risk of de­vel­op­ing sec­ondary con­di­tions that can be de­bil­i­tat­ing and even lifethreat­en­ing—e.g. deep vein throm­bo­sis, uri­nary tract in­fec­tions, mus­cle spasms, os­teo­poro­sis (de­gen­er­a­tion of bone), pres­sure ul­cers, chronic pain, and res­pi­ra­tory com­pli­ca­tions.

• Acute care, re­ha­bil­i­ta­tion ser­vices and on­go­ing health main­te­nance are es­sen­tial for pre­ven­tion and man­age­ment of th­ese con­di­tions. Pre­ven­tion The lead­ing causes of spinal cord in­jury are road traf­fic crashes, falls and vi­o­lence (in­clud­ing at­tempted sui­cide). A sig­nif­i­cant pro­por­tion of trau­matic spinal cord in­jury is due to work or sports-re­lated in­juries.

Ef­fec­tive in­ter­ven­tions are avail­able to pre­vent sev­eral of the main causes of spinal cord in­jury, in­clud­ing im­prove­ments in roads, ve­hi­cles and peo­ple’s be­hav­iour on the roads to avoid road traf­fic crashes, win­dow guards to pre­vent falls, and poli­cies to thwart the harm­ful use of al­co­hol and ac­cess to firearms to re­duce vi­o­lence.

Im­prov­ing care

Many of the con­se­quences as­so­ci­ated with spinal cord in­jury do not re­sult from the con­di­tion it­self, but from in­ad­e­quate med­i­cal care and re­ha­bil­i­ta­tion ser­vices, and from bar­ri­ers in the phys­i­cal, so­cial and pol­icy en­vi­ron­ments.

Es­sen­tial mea­sures for im­prov­ing the sur­vival, health and par­tic­i­pa­tion of peo­ple with spinal cord in­jury in­clude the fol­low­ing:

1. Timely, ap­pro­pri­ate pre-hos­pi­tal man­age­ment: quick recog­ni­tion of sus­pected spinal cord in­jury, rapid eval­u­a­tion and ini­ti­a­tion of in­jury man­age­ment, in­clud­ing im­mo­bi­liza­tion of the spine.

2. Acute care (in­clud­ing sur­gi­cal in­ter­ven­tion) ap­pro­pri­ate to the type and sever­ity of in­jury, de­gree of in­sta­bil­ity, pres­ence of neu­ral com­pres­sion, and in ac­cor­dance with the wishes of the pa­tient and their fam­ily.

3. Ac­cess to on­go­ing health care, health education and prod­ucts (e.g. catheters) to re­duce risk of sec­ondary con­di­tions and im­prove qual­ity of life.

4. Ac­cess to skilled re­ha­bil­i­ta­tion and men­tal health ser­vices to max­i­mize func­tion­ing, in­de­pen­dence, over­all well­be­ing and com­mu­nity in­te­gra­tion. Man­age­ment of blad­der and bowel func­tion is of pri­mary im­por­tance.

5. Ac­cess to ap­pro­pri­ate as­sis­tive de­vices that can en­able peo­ple to per­form ev­ery­day ac­tiv­i­ties they would not oth­er­wise be able to un­der­take, re­duc­ing func­tional lim­i­ta­tions and de­pen­dency.

6. Specialized knowl­edge and skills among providers of med­i­cal care and re­ha­bil­i­ta­tion ser­vices are needed to at­tend to some­one with the in­jury.

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