• Cervical cord injury
• RTA and falls are the commonest cause. ⅓ require intubation.
• The impact on the resp system depends on the level of injury
• C1-3 - complete paralysis and death if not ventilated immediately
• C3-5 - ventilation often needed acutely. Improvement in lung mechanics over time
• C6-8 - diaphragm and accessory muscles intact
• Can get see-saw breathing pattern
• Reduced Vt, atelectasis, secretion retention, V/Q mismatch, alveolar hypoventilation
• Treatments
• Turning
• Abdominal binding
• NIV may help
• Bronchoscopy
• Mechanical ventilation
• Domicillary ventilation
• Tracheostomy
• Exercise training
• Diaphragmatic pacing
• Mucolytics
• Physio
• Complications
• Neurogenic shock can occur
• Neurogenic bladder
• Paralytic ileus/delayed gastric emptying
• Constipation
• Stress ulceration
• Sympathetic hyperreflexia
• TED
• Spasticity usually occurs at 2-3/52 but can occur within hours or months later
• Other considerations
• Psychological aspects
• Pain management
• Spasticity
• Renal stones
• Metabolic considerations
• Hyperglycaemia
• Steroids (not used in UK routinely)
• CEACCP
  Link:ceaccp.oxfordjournals.org/content/9/3/82.full.pdf
  
• CEACCP
  Link:ceaccp.oxfordjournals.org/content/early/2013/07/11/bjaceaccp.mkt021.full.pdf