The new American College of Surgeons’ (ACS) guidelines provide a practical guide for the evaluation and management of an adult patient with a spinal injury, including both spinal column fracture and spinal cord injury (SCI).
These guidelines are an indispensable resource for trauma centers in developing and updating protocols for the management of patients with spine injury.
Topics covered include:
- Epidemiology of spinal injury
- Pre-hospital spinal motion restriction
- Injury evaluation, including cervical collar clearance, appropriate imaging, physical exams, and injury classification systems
- Indications for operative and nonoperative management
- Use and limitations of mean arterial pressure-directed therapy
- Specific areas of management, including venous thromboembolism prophylaxis, neurogenic and spinal shock, SCI-induced bradycardia, ventilator management in a patient with high SCI, and analgesia
- Prevention and management of acute autonomic dysreflexia, spasticity, pressure ulcers, and neurogenic bowel and bladder during a prolonged hospital course
- Early mobilization and rehabilitation
The guidelines also provide advice on integrating these best practices into trauma center protocols and performance improvement processes.