Case Study: Spinal Cord Injury
Concordia University, St. Paul
NUP 353: Nursing Role In The Acute Care Setting
C.R. is a 42-year-old white male who fell from a 60-foot scaffold while working on the construction of a new building. He is admitted to the emergency department (ED) by ambulance and is strapped to a rigid backboard with cervical immobilization. At the site of the accident, C.R.'s co-workers immobilized his body until the ambulance arrived. His supervisor called his wife.
Question #1: Using the principles of prioritization that you have learned in this course, answer the question: what prioritization category does cervical immobilization fall under?
Cervical immobilization is the highest priority during the primary injury phase. The main
prehospital goals immediately following a spinal cord injury are to maintain the ABCs and
prevent any further extension of the spinal cord in order to prevent a secondary injury. At this
time, they are unaware what type of spinal injury that C.R. has. Stabilizing the injury site helps
to eliminate damaging motion (Harding, et al., 2020).
C.R.'s wife arrives at the emergency department (ED) at the same time the ambulance arrives. She is very agitated and crying. He sees her as he is wheeled into the ED, reassures her that he is okay, and tells her he fell at work. You take her to a waiting room, explaining that she can see her husband as soon as he is stabilized.
Question #2: Comment on your feelings about the wife being taken to the waiting room and told she will need to wait until the patient is stabilized.
Taking the wife to the waiting room was the right thing to do and it will also be easier to find and
communicate with her in a specific room. As a nurse, it is important to make sure the wife feels
as if the care team cares about her state as well as her husbands. C.R. 's wife should be updated
of his condition as soon as possible, as she will be his caregiver. When C.R. is stabilized, a nurse
should fight for the wife to be in the room with him as soon as possible. Trauma such as this
affects not only the patient, but also everyone involved and it will be important to be empathetic
towards the family.
Question #3: Using therapeutic communication, write what you could say to the patient at this point in the care of the patient/family.
I would make sure to sit in front of C.R., have an open posture leaning forward toward him, and
establish eye contact while speaking with him. When speaking with C.R., I would ensure to show
empathy, genuineness, respect, and attentive listening (Harding et al., 2020). I will be sensitive
and try to understand C.R. 's current feelings and situation by asking him broad opening
questions about his feelings, beliefs, pain, and needs. While C.R. is going through a difficult and
critical time, I would also try not to give any false hope and be