However, their use requires careful monitoring of intracranial pressure since these medications can negate neurologic exam results. Always suspect the presence of these types of injuries. This is manifested by hypotension and bradycardia. A foley catheter should be inserted to prevent bladder distention and assess renal function as an indicator of perfusion. This includes proper immobilization and continuous re-evaluation of the neurologic status.
Definitive treatment is performed at a center with neurosurgical or orthopedic spine expertise.
Controlled studies have demonstrated improved neurologic outcome in patients with spinal cord injury who receive steroids early after the injury. Steroid administration is indicated for non-penetrating spinal cord injury, but it must be given within 8 hours of the injury. Careful transfer of the patient must be carried out, and pretransfer thought given to any untoward events which might be anticipated by the patient's status. Pretransfer intubation may need to be considered, depending upon severity of injury, distance, mode of transfer, and sophistication of personnel accompanying the patient. The GMO can help prevent spinal cord injuries by encouraging each patient to use seat belts, drive a car with an airbag, and avoid driving while intoxicated.