SMACC 2014 PK spinal cord injury
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Transcript of SMACC 2014 PK spinal cord injury
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Spinal Cord Injury
Management Controversies in
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A P
K S
MA
CC T
alk
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#2
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ASIA Scale
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Spinal Shock
Neurogenic Shock
from acute spinal cord injuryloss of reflexes and flaccid paralysistransient (days to months)no specific treatment
haemodynamic phenomenondue to sympathetic denervation
and unopposed vagal activityfluids/pressors
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http://www.learnicu.org/Docs/Guidelines/CSCMAcuteManagementSpinal.pdf#5http://journals.lww.com/neurosurgery/toc/2013/03002
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Occiput
Back
?#7
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#8
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#9
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Image Credit DOI: 10.4103/0970-9185.117053#10
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Cerebral Perfusion
Pressure
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Spinal Cord Perfusion
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#12
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Episode 1: A New Hope?The NASCIS Trilogy
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Episode 2: The steroids strike back
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Standard of Care
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Episode 3: Return of the steroids (oh please can we stop the Star Wars theme now?...)
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2002 & 2012...
Oh no it’s worse than the Phantom Menace...
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Image Credit: Seth Anderson on Flickr, https://secure.flickr.com/photos/swanksalot/
Text Credit: Chris Nickson on LITFL, http://lifeinthefastlane.com/education/ccc/trauma-literature-summaries/#18
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PMID 23417182#19 image credit: http://antisteroid.wordpress.com
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Kudos to Oli Flower and ICN Podcast #3
http://www.intensivecarenetwork.com/index.php/icn-activities/icn-podcasts/144-podcast-3-the-acute-
management-of-spinal-cord-injury
#20
Thanks for watching