The Basics: Spinal Trauma With Ian Wedmore

In this podcast episode, Dennis interviews Ian, an ER physician with experience in wilderness medicine, about spinal trauma. They discuss the initial approach to spinal trauma, the process of clinically clearing the spine, the neuro exam for spinal trauma, and the treatment of neurogenic shock. They also cover the goals of fluid resuscitation, the use of vasopressors, and the prevention of complications such as pressure injuries and hypothermia. The episode concludes with a discussion on the use of steroids in spinal cord injuries. Takeaways The initial approach to spinal trauma involves utilizing the MARCH algorithm and maintaining C-spine precautions until the patient can be clinically cleared. The neuro exam is crucial in determining the grade of spinal trauma and whether neurogenic shock is present. Treatment of neurogenic shock involves fluid resuscitation and the use of vasopressors to maintain blood pressure. Nursing care for spinal trauma includes preventing pressure injuries, monitoring for respiratory complications, and preventing hypothermia. Steroid use is not recommended in spinal cord injuries due to the associated risks.

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