Alan was diving off cliffs with his friends. He slipped as he jumped and landed his head first into the pool of water below. As he entered the water head first, he hit his head on a rock and sustained a spinal cord injury
Two vertebras in his neck were fractured, and his spinal cord was permanently damaged.
a. Alan was told he was in spinal shock for a month after the incident. What is spinal shock?
b. Alan also doesn't understand what autonomic dysreflexia is. How can you explain it so he understands what is happening to him?
c. Alan also asks you about the spasms and contractures he frequently is having.
d. What other things can Alan expect with this new adjustment he has to make with his body and lifestyle?
Students' answers should include the following:
a. Spinal shock, also known as areflexia, is loss of the sympathetic reflex activity below the injury levels 30 to 60 minutes after the initial injury. Besides paralysis, hypotension; warm, dry skin; and bradycardia are present.
Respiratory failure can occur if, in the thoracic or in Alan's case, cervical region is injured.
b. Autonomic dysreflexia is the exaggerated sympathetic nervous system response in spinal cord injuries above T6.
c. Other symptoms of autonomic dysreflexia are severe hypotension, anxiety, nasal stuffiness, flushed skin, blurriness, nausea, pounding headache, and slow heart rate.
Can lead to seizures and death; treated with antihypertensives, raising HOB, and relieving precipitating causes
d. Other things for Alan to understand is that he is at risk for pressure ulcers, respiratory infections, urinary and bowel issues, contractures, and spasticity of muscles.
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