Case Study - Spinal Cord Injury in Disasters and Conflicts: Difference between revisions

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== Patient Characteristics ==
== Patient Characteristics ==
=== Past Medical History ===
=== Past Medical History ===
A 27-year-old male sustained a spinal cord injury caused during the 2015 Nepal Earthquake. He was admitted to the Spinal Injury Rehabilitation Centre three weeks later, after being referred from another hospital with a diagnosis of T12 – L1 fracture that had been surgically managed. He was discharged five months post-injury.
A 27-year-old male sustained a [[Spinal Cord Injury|spinal cord injury]] caused during the 2015 Nepal Earthquake. He was admitted to the Spinal Injury Rehabilitation Centre three weeks later, after being referred from another hospital with a diagnosis of T12 – L1 [[fracture]] that had been surgically managed. He was discharged five months post-injury.


== Examination Findings ==
== Examination Findings ==
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=== Medical Management ===
=== Medical Management ===
* Pain Management
* [[Pain Management in Spinal Cord Injury|Pain Management]]
* Wound Management (Multiple Soft-tissue Injury).
* [[Wound Debridement|Wound Management]] (Multiple Soft-tissue Injury).


=== Nursing Management ===
=== Nursing Management ===
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=== Physiotherapy Management ===
=== Physiotherapy Management ===
'''Range of Movement:''' Passive ROM exercises of bilateral lower limbs, active ROM exercises of bilateral upper limbs  
'''Range of Movement:''' Passive ROM exercises of bilateral lower limbs, active ROM exercises of bilateral upper limbs.


'''Strength:''' Strengthening of upper back and upper limbs
'''Strength:''' Strengthening of upper back and upper limbs.


'''Mobility (Room and Toilet):''' Independent in bed mobility and pressure relief techniques, transfers from bed to wheelchair independently.  
'''Mobility (Room and Toilet):''' Independent in bed mobility and pressure relief techniques, transfers from bed to wheelchair independently.  


'''Wheelchair Skills:''' Basic and advanced, balance training ongoing in static and dynamic settings
'''Wheelchair Skills:''' Basic and advanced, balance training ongoing in static and dynamic settings.


'''Education:''' DVT and its prevention, education to caregiver and patient on ROM exercises and bedside positioning.
'''Education:''' [[DVT and PE in individuals with SCI|DVT]] and its prevention, education to caregiver and patient on ROM exercises and bedside positioning.


=== Occupational Therapy Management ===
=== Occupational Therapy Management ===
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* Educated about and accomplished home modification, initiated a return to work and leisure activities (artist) and has regained his previously role in his family and community.  
* Educated about and accomplished home modification, initiated a return to work and leisure activities (artist) and has regained his previously role in his family and community.  
* Psychological: Realisation counselling on expected functional outcomes, deep relaxation therapy, individual/group session on safe reintegration to community, group education on sexuality and fertility after an SCI, education on disability rights, encouraged to participate actively all rehabilitation activities, including music therapy and yoga.  
* Psychological: Realisation counselling on expected functional outcomes, deep relaxation therapy, individual/group session on safe reintegration to community, group education on sexuality and fertility after an SCI, education on disability rights, encouraged to participate actively all rehabilitation activities, including music therapy and yoga.  
* Wheelchair Service Department provided a Motivation three-wheeler wheelchair.  
* [[Wheelchair Assessment|Wheelchair]] Service Department provided a Motivation three-wheeler wheelchair.


== Functional Outcome Measure: ==
== Functional Outcome Measure: ==
AIS  
[[American Spinal Cord Injury Association (ASIA) Impairment Scale|AIS]]


* On Admission:  T12 AIS- A;
* On Admission:  T12 AIS- A;
* On Discharge:  T12 AIS –A   
* On Discharge:  T12 AIS –A   
<br>
<br>
SCIM  
[[Spinal Cord Independence Measure (SCIM)|SCIM]]


* On Admission: 10  
* On Admission: 10  
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* Has been working as a Peer Counsellor at SIRC since 2016.  
* Has been working as a Peer Counsellor at SIRC since 2016.  
* Active role model to newly injured people with a Spinal Cord Injury
* Active role model to newly injured people with a Spinal Cord Injury
* An excellent artist!
* An excellent artist.


== References  ==
== References  ==

Revision as of 16:31, 12 March 2022

Original Editors - Naomi O Reilly

Top Contributors - Naomi O'Reilly, Kim Jackson, Rucha Gadgil and Olajumoke Ogunleye      

Title[edit | edit source]

T12 - L1 Spinal Cord Injury following 2015 Nepalese Earthquake [1]

Thanks to Humanity and Inclusion for Case study taken from Early Rehabilitation in Conflicts and Disasters - Field Handbook

Abstract[edit | edit source]

A 27-year-old male admitted to a Spinal Injury Rehabilitation Centre 3-weeks after sustaining a T12-L1 Spinal Cord Injury managed surgically following Nepal Earthquake.

Key Words [edit | edit source]

Spinal Cord Injury, Earthquake, T12-L1 Fracture, Rehabilitation

Patient Characteristics[edit | edit source]

Past Medical History[edit | edit source]

A 27-year-old male sustained a spinal cord injury caused during the 2015 Nepal Earthquake. He was admitted to the Spinal Injury Rehabilitation Centre three weeks later, after being referred from another hospital with a diagnosis of T12 – L1 fracture that had been surgically managed. He was discharged five months post-injury.

Examination Findings[edit | edit source]

Observation[edit | edit source]

On Admission: Bedridden, Foleys Catheter, Irregular bowel habit and totally dependent with activities of daily living. All vital signs were stable.

Medical Management[edit | edit source]

Nursing Management[edit | edit source]

  • Bladder and Bowel Management
  • Education on Intermittent Catheterisation, Personal Care, Bowel Routine, Prevention of Complications, Pressure Injury and Urinary Tract Infection.

Physiotherapy Management[edit | edit source]

Range of Movement: Passive ROM exercises of bilateral lower limbs, active ROM exercises of bilateral upper limbs.

Strength: Strengthening of upper back and upper limbs.

Mobility (Room and Toilet): Independent in bed mobility and pressure relief techniques, transfers from bed to wheelchair independently.

Wheelchair Skills: Basic and advanced, balance training ongoing in static and dynamic settings.

Education: DVT and its prevention, education to caregiver and patient on ROM exercises and bedside positioning.

Occupational Therapy Management[edit | edit source]

  • Independent in most activities of daily living, including feeding, upper and lower body dressing (in chair), upper and lower body bathing and grooming, toilet transfer and use of toilet, all level transfer, basic and advanced wheelchair skills.
  • Educated about and accomplished home modification, initiated a return to work and leisure activities (artist) and has regained his previously role in his family and community.
  • Psychological: Realisation counselling on expected functional outcomes, deep relaxation therapy, individual/group session on safe reintegration to community, group education on sexuality and fertility after an SCI, education on disability rights, encouraged to participate actively all rehabilitation activities, including music therapy and yoga.
  • Wheelchair Service Department provided a Motivation three-wheeler wheelchair.

Functional Outcome Measure:[edit | edit source]

AIS

  • On Admission: T12 AIS- A;
  • On Discharge: T12 AIS –A


SCIM

  • On Admission: 10
  • On Discharge: 69

Community Reintegration[edit | edit source]

  • Has been working as a Peer Counsellor at SIRC since 2016.
  • Active role model to newly injured people with a Spinal Cord Injury
  • An excellent artist.

References [edit | edit source]

  1. Lathia C, Skelton P, Clift Z. Early Rehabilitation in Conflicts and Disasters. Handicap International: London, UK. 2020.