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A 14-year-old boy dives into the shallow end of a swimming pool and hits his head against the bottom. When he is rescued, he shows a complete lack of neurologic function below the neck. He is still breathing on his own, but he cannot move or feel his arms and legs. The paramedics carefully immobilize his neck for transportation to the hospital, and they alert the emergency department to his impending arrival. Once there, which of the following would most likely have an immediate benefit for this patient?
A. Hyperbaric oxygenation
B. IV antibiotics
C. IV high-dose corticosteroids
D. Massive diuresis induced by loop diuretics.
E. Surgical decompression of the cord
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yes C imeediatley when Spine involvement is supecetd it seem to improver overall Outcome in Mobility
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C. The predinosolne regimen.
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The correct answer is C.
There is some evidence that high-dose corticosteroids administered as soon as possible after the injury will result in a better ultimate outcome. Although the true medical value of this observation may be debatable, there is a legal imperative to use the treatment, which offers some hope and has not been shown to be detrimental.
Hyperbaric oxygenation (choice A) has no role in the acute management of neurologic injuries.
Antibiotics (choice B) are likewise unlikely to affect the course of events in a case like this.
Although diuresis (choice D) is part of the therapy used to decrease intracranial pressure, the agent of choice is mannitol, and the indications do not include spinal cord injury.
Surgical decompression (choice E) might be done, but the decision is individualized depending on the findings on MRI. Not all patients are automatically and immediately taken to the operating room.
