Critical Path for Cervical Cord Injuries Considering the Psychological Status of Patients

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  • 精神的側面の介入を目指した頚髄損傷クリティカルパスの新規作成
  • セイシンテキ ソクメン ノ カイニュウ オ メザシタ ケイズイソンショウ クリティカルパス ノ シンキ サクセイ

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Abstract

<p>We have used the surgery-based critical paths for the cases of cervical cord injuries in our hospital. This path has several characteristics which are divided into preoperative course for the emergency operation with the postoperative rehabilitation, and furthermore, are classified by the level of injury of C5 or above and of C6 or below, considering the possibility of respiratory disturbances. Based on our experiences of these injuries, we revised the path so that health care providers can easily share information of these patients, thereby understanding the extent of cervical spinal cord injuries. We evaluated 9 patients that suffered from the cervical spinal cord injury (ASIA A or B) from 2007 to 2013. The clinical records were investigated retrospectively. Results suggested that mental support such as intervention of medical social worker and allotment of the palliative care team in the early stage after cervical cord injuries were important in these cases. Therefore, notice entry for prognosis of handicap and regular conferences were added to the existing path and Fink's crisis model was also applied. We believe that these critical paths are much useful for both patients and health care providers in the treatment of cervical cord injuries.</p>

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