Spinal Cord Injury with Deficits
Critical Care Guidelines
- Establish baseline ASIA grade
Supplemental oxygen as required (maintain SpO2 > 90%)
Establish IV or IO access
Secure airway if required, assess for hypoventilation, ETCO2 monitoring indicated
- Refer to procedural guidelines: Anesthesia
Manage hemodynamic instability
- MAP > 80 – 85mmHg for isolated spinal cord injury
- In cases of distributive spinal shock early vasopressors may be required to maintain a higher than normal MAP to ensure spinal cord perfusion.
- Crystalloid and/or vasopressor administration may be required
- Mechanical ventilator LTV 1000 or LTV 1200
- Refer to procedural guidelines: Mechanical Ventilation
Maintain appropriate blood glucose levels
Arterial or venous blood gas analysis
- Adjust mechanical ventilation to ensure adequate oxygenation, appropriate ventilation, and safe ground ventilating parameters.
Neurological emergencies or urgencies are considered to be time sensitive and may require immediate surgical or non-surgical intervention. Minimizing scene times may have impact on patient outcomes.