1. Suction, cough, tracheostomy care, prn.

        2. Oxygen, ventilator car

        3. Monitor blood gas levels.

      2. Goal: prevent further damag

        1. Immobilize spin

        2. Firm mattress, Stryker frame, Foster frame, CircO-electric bed, traction, braces (see II Fractures, p. 580).

        3. Skeletal traction via tongs: Crutchfield, Gardner-Wells (see II Fractures, p. 573).

        4. Halo traction (see II Fractures, pp. 574, 580).

      3. Goal: relieve edema: anti-inflammatory medications, corticosteroids.

      4. Goal: relieve discomfort: analgesics, sedatives, muscle relaxants.

      5. Goal: promote comfort:

        1. Maintain fluid intake: PO/IV, I&O.

        2. Increase nutritional intak

        3. Prevent contractures and decubit

        4. Assist patient to deal with psychosocial issues, , role changes.

        5. Begin rehabilitation plan.

      6. Goal: prevent complications.

        1. Monitor for spinal shock during initial phase of injury (see XII Spinal shock, p. 595).

        2. Monitor for hyperreflexia with severed spinal cord injuries (see XIV. Autonomic hyperreflexia, p. 596).

      7. Goal: health teaching

        1. Self-care techniques for highest level of independence; include significant others in teachin

        2. How to use ambulation assistive devices (battery-operated wheelchair controlled by mouthpiece or hand controls, depending on level of paralysis).

        3. Identify community resources for followup care and career counselin

        4. Signs and symptoms of autonomic hyperreflexia (see XIV. p. 596).

        5. Methods to prevent skin breakdown, infections of respiratory, urinary tract.