5-12. PATHOPHYSIOLOGY

a. It should be assumed that any unconscious patient who is the victim of an accident may have a spinal injury. Detection of spinal injuries can be difficult. The patient may not have signs or symptoms of damage to the spinal cord immediately. It is often assumed that a person with spinal cord damage will be completely or partially paralyzed. This is not always the case. The patient's spinal cord may be damaged, but initially he may not have paralysis or paresis (partial paralysis, weakness).

NOTE: There is a difference between paralysis and paresis. Paralysis is loss of movement; paresis is weakness or incomplete loss of muscular power.

b. Be cautious in moving the patient. Incorrect movement may cause irreparable spine damage even if there are no signs or symptoms of spinal injury.

c. Do not rely on the fact that the patient does not exhibit the usual signs/symptoms of spinal cord injury. The patient's ability to move his extremities or the absence of numbness, tingling, and other signs of neurological damage only indicate the spinal cord is intact so far. This is NOT an indication that there is no injury to the spinal cord.