b. B - Breathing. If needed, administer oxygen in high concentration to any
patient with marginally effective respirations. (The spinal cord injury may have resulted
in edema to the cord. If the necessary oxygen is not delivered, cell death can occur).
c. C - Circulation. Support and monitor the patient's cardiovascular system.
d. C - Cervical Spine Stabilization. Be sure the patient's head and neck have
been temporarily stabilized. (This should have been done when his injuries were being
assessed.
e. C - Consciousness. Determine the patient's level of consciousness. Use
the Glasgow Coma Scale.
f. Control Bleeding. Control bleeding to prevent the loss of blood volume, a
possible life-threatening condition.
(1)
Administer an IV of lactated Ringer's solution.
(2) Apply medical anti-shock trousers (MAST), if necessary. Bleeding can
sometimes be controlled with MAST garments, depending on the location of the injury
and the cause of the bleeding. MAST garments are considered to be an intermediate
life support measure. The garments are used to create a pressure against the flow of
blood thus stopping bleeding.
g. Cover Patient. Keep the patient covered. The patient cannot conserve heat
because his body has lost sympathetic tone and blood vessels and arteries have lost
their vasoconstriction.
h. Seizures. Be prepared for seizures. Ordinarily, you would not restrain a
patient having a seizure. A patient with a spinal cord injury must not move his head
and/or neck very much. Therefore, such patients must be restrained during a seizure.
i. Immobilize the Patient on a Long Back Board. Depending on the accident
and the position in which the patient is found, he may first need to be splinted onto a
short spine board or Kendrick extrication device. With his head, neck, and back
stabilized, the patient can then be placed on a long back board.
j. Neurological and Vital Sign Checks. Make frequent neurological and vital
sign checks on the patient. Record the results.
MD0572
5-29