spinal cord injury

[FutureDocDO]

Just curious. If a patient comes in with a spinal cord injury before midnight, how soon do you operate? Do you operate right away, as soon as possible, or let him lay in bed 'til late next morning (after 9 am)? Thanks for any response!

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[tussy]

Just curious. If a patient comes in with a spinal cord injury before midnight, how soon do you operate? Do you operate right away, as soon as possible, or let him lay in bed 'til late next morning (after 9 am)? Thanks for any response!

As for your specific question regarding spinal cord injuries i can't answer, however regarding time: Our hospital operateds 24/7. When i am on call i don't look at the clock when i book a case: whether it's 11am or 11pm, doesn't make a different. Cases are booked on a priority system based on how urgent it is. We use 4 levels: Level 1: Immediately life/limb threatening: goes immediately to OR (eg. trauma lap with unstable vitals, ruptured AAA). Level 2: within 2 hours (eg. open fracture, perforated viscus with sepis, etc). Level 3: within 8 hours (eg. appendicitis) and Level 4:within 24 hours (eg. most fractures, lap choles for biliary colic etc.).

Most hopsitals have a similar system. I just book the case as the appropriate level and the OR calls me when they are sending for the patient. If i book a level 3 case at 11pm then the case will happen overnight.

I hope this sort of addresses your question

 

[mtheman]

From my experiences it goes by a case by case basis. If there is bone in the spinal canal they usually go right away. Most cases you could put in traction or into a halo and go the next day. You also have to take into account the patients vitals. Sometimes the patients with the worst injuries can't go for a day or two, when they stabalize. I am not a neuro. or spine, but my uncle is a neurosurgeon (ret.) who did a lot of spinal trauma and this is just a short summary of his answer.

Hope this helps

 

[FutureDocDO]

Thanks you two!