Acute spinal injury ( <48hrs)
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Pressure sore prevention. If the patient is on a trauma trolley, ensure all glass etc is well cleaned up.

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Patients are poikilothermic. Ensure environmental temperature near 37degrees if patient exposed. Improves over a few months after injury.

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May 18, 2011
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Patient still require anaesthesia for procedures in areas of sensory deficit. The patient's reflexes are usually intact, and will be at risk of autonomic dysreflexia

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Quadraplegic patients use abdominal muscles to breath, and chest falls in on inspiration. This can be mistaken for bilateral flail chest in the patient presenting following major trauma

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Oct 16, 2011
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At risk of autonomic dysreflexia. Ensure adequate analgesia. Ensure empty bladder.

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Beware of relative tachycardia. Baseline HR probably 50-60, if >70 consider other injuries in acute trauma.

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Consider the physiological consequences of a sympathectomised heart

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The patient may have an unopposed vagal/parasympathetic tone. Consider giving Atropine 1.2mg IV prior to procedures.

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Avoid remifentanil as this is likely to cause severe bradycardia due to patients unopposed parasympathetic tone.

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Aug 06, 2011
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Circulation time is decreased, so give longer time for induction agents to work.

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