Computerised Asia scoring for SCI- Nursing role
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Computerised Asia scoring for SCI- Nursing role
- 1. Sumi Sunny Research Staff Nurse Guide:-Dr Deepak Agrawal Addl. Professor Department of Neurosurgery JPNATC AIIMS
- 2. A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease The American Spinal Injury Association (ASIA) is widely used to document sensory and motor impairments following SCI It is based on neurological responses, touch and pinprick sensations tested in each dermatome
- 3. To document sensory and motor impairments following SCI. To categorise the patients and give appropriate care. To assess nursing role in using ASIA score in SCI
- 4. 1. MOTOR SCORING 2. SENSORY SCORING
- 6. C5 – Elbow flexors C6 – Wrist extensors C7 – Elbow extension C8 – Finger flexors T1 – 5th digit abduction L2 – Hip flexion L3 – Knee extension L4 – Ankle dorsiflexion L5 – Long toe extension S1 – Ankle plantar flexion
- 7. 1. ASIA-A 2. ASIA-B 3. ASIA-C 4. ASIA-D 5. ASIA-E
- 8. Complete SCI No motor or sensory function is preserved Nursing Implication: ◦ To prognosticate the patient ◦ Appropriate care should be provided to reduce high risk of bed sore
- 9. Incomplete SCI Sensation : Present Motor function: Absent Nursing Implication: ◦ As sensation is low care should be provided to prevent bed sore
- 10. Incomplete SCI Sensation: Present (complete) Motor: Present but grade 3 or less. Nursing Implication: ◦ Nurse motivates patient and their relatives
- 11. Incomplete SCI Sensory: Present (complete) Motor: Present but have a grade more than3. Nursing Implication: ◦ Motivate the patient for physiotherapy and rehabilitation.
- 12. Incomplete SCI Motor and sensory functions are normal It implies the presence of a spinal cord injury but without detectable neurological deficits.
- 13. TOTAL CASES ADMISSI ONS OPERAT ED DEATH (%) NON- OPERAT ED DEATH (%) CERVICAL SPINE INJURY 289 178 115 5.6% 174 4.6% DORSAL SPINE INJURY 112 69 46 - 66 1.7% LUMBAR SPINE INJURY 119 60 30 - 89 1.7%
- 14. TOTAL CASES COMPLETE INCOMPLETE DEATH (%) CERVICAL SI 289 116 173 5.9% DORSAL 112 31 81 0.89% LUMBAR 119 19 100 0.89%
- 15. Manual system of calculating score is: ◦ Cumbersome ◦ Time consuming Computerized system was developed: ◦ For easy assessment and entry of motor and sensory powers for automatic calculation of ASIA Score Need of this system
- 19. Nurses can play a vital role in accurate assessment of ASIA score using computerized software. This will help in research and follow up of SCI patients. Document sensory and motor impairments following SCI. Helps to prognosticate the patient. Categories the patients and give appropriate care.
Notas del editor
- .Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis.
- This form is used to do ASIA scoring-its divided into sensory and motor scoring chart.The sensory levels are scored on a 0- 2 scale bases for each dermatome on both right and left side.Each dermatome is tested for light touch and pinprick sensation and labeled as NT( not testable) if cannot be tested.0- given if the sensation is absent1- if the sensation is present but impaired2- if the sensation is normal
- Motor scoring chart – here the reflexes are checked and scoring is given on a 0 to 5 scale basis.0- is given for total paralysis1- for palpable and visible contraction2-active movements, full range of motion gravity eliminated3-active movements, full range of motion against gravity 4- active movements, full range of motion against gravity and provides some resistance5- active movements, full range of motion against gravity and provides normal resistanceNT- not testable
- This helps in classifying the patients into 5 groups.
- ( below the neurological level of injury )
- Less than ½ of the key muscles below the neurological level have a grade 3 or less.
- At least ½ of the key muscles below the neurological level have a grade 3 or better.