Abstract: Spinal Cord Injury: Introduction to Basic Health Care Considerations

Catherine W. Britell, MD. "Spinal Cord Injury: Introduction to Basic Health Care Considerations."
<1995. http://weber.u.washington.edu/~britell/sci_intro.html> (13 July 1996).

Objectives:
* To educate lay persons about health care for patients with spinal cord injury (SCI). The incidence and causes of spinal cord injury are discussed, as well as the three phases of care for SCI patients: acute care, rehabilitation, and sustaining health maintenance/ongoing maximization of function. Respiratory management, gastrointestinal care, genitourinary care, skin care, prevention of blood clots, maintenance of range of motion in the joints, and common medical complications are discussed.

Conclusions:
* "Paraplegics can now expect a nearly normal life-span, while quadriplegics die 5-20 years earlier, depending on the patient's age at injury and completeness of the injury. The major cause of death in SCI is pulmonary disease, with cardiovascular disease and genitourinary infection in lesser numbers."
* "Following almost every SCI, the bladder will not empty when it fills up. Therefore, it must be emptied mechanically in order to prevent over-stretching, standing urine, infection, and kidney damage. This is done at first by means of an indwelling catheter and closed drainage system. When the patient is stable, intermittent catheterization is started, inserting a small rubber tube every 4-6 hours to empty the bladder."
* "Aspects of rehabilitation include regaining as much strength and function in the trunk and extremities as possible, management of bladder and bowel function, and independent living and vocational rehabilitation."
* Spinal cord injury patients are more susceptible to bladder infections, and must be monitored carefully when any symptom of infection occurs. Untreated infections of the bladder or urinary tract can be life threatening.
* Autonomic Hyperreflexia (the sudden onset of headache and hypertension), a life-threatening medical emergency in persons with spinal cord injury, is most often caused by bladder outlet obstruction.
* Persons having sustained spinal cord injuries require ongoing care and monitoring in order to maintain the highest possible quality of life. "Regular medical evaluations should be done every year or more often if there are health problems. In addition to the usual adult health concerns, annual evaluation of the urinary system should include a sensitive measure of kidney function, ultrasound or x-ray examination of the urinary tract, and evaluation of voiding, as well as appropriate cancer screening."
* "With optimal interdisciplinary care, the individual who has sustained a spinal cord injury can lead a full, healthy, productive, and rewarding life."

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