[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-532703-105":59,"doc-detail-532703-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","cervical-spinal-cord-trauma-best-next-step-in-management-urinary-catheterization","Cervical Spinal Cord Trauma: Best Next Step in Management - Urinary Catheterization","","A 20-year-old hockey player sustains a headfirst fall with inability to move extremities, abnormal pain and temperature sensation below the clavicles, and quadriplegia. CT shows a C5 burst fracture with posteriorly displaced fragments impinging the spinal cord, consistent with anterior cord syndrome. Disruption of autonomic pathways involved in bladder control can cause acute urinary retention, so bladder catheterization should be performed to prevent distension and injury. Other listed interventions do not address the immediate autonomic bladder complication.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cervical-spinal-cord-trauma-best-next-step-in-management-urinary-catheterization/532703/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cervical-spinal-cord-trauma-best-next-step-in-management-urinary-catheterization/532703.png","ImageObject",300,407,{"name":92,"@type":93},"\tCallum ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-09",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is bladder catheterization the best next step for this patient?","Question",{"text":112,"@type":113},"Quadriplegia with anterior cord syndrome suggests disruption of autonomic tracts controlling bladder function, leading to acute urinary retention. Catheterization prevents bladder distension and possible injury.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What key neurologic findings support the diagnosis of anterior cord syndrome?",{"text":117,"@type":113},"The patient has absent pinprick and temperature sensation below the clavicles and bilateral paralysis, while vibratory sensation is preserved. This pattern fits anterior spinal cord involvement.",{"name":119,"@type":110,"acceptedAnswer":120},"Does an anxious but breathing-stable patient need immediate orotracheal intubation?",{"text":121,"@type":113},"No. With normal respirations and preserved airway status, further airway protection or mechanical ventilation is not indicated at this time.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},532703,1791970216,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},137451211410,"https://ap-avatar.wpscdn.com/avatar/2000bb0a9246f588df?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786362646172706240","Settings  \nA 20-year-old hockey player is brought to the emergency department 30 minutes after falling headfirst into the hockey rink boards.He did not loseconsciousness during the impact but was unable to move his arms and legs afterward.The patient was placed in a rigid cervical collar andtransported to the hospital on a backboard;2 large-bore intravenous catheters were inserted en route.On arrival,blood pressure is 128/78 mmHg,pulse is 102/min,and respirations are 14/min.The patient is alert and appears anxious.Cardiopulmonary examination is normal.Neurologicexamination shows intact cranial nerves.Pinprick and temperature sensation are absent below the level of the clavicles;vibratory sense is intact.The patient is still unable to move his extremities.CT scan of the cervical spine reveals a burst fracture of C5 with impingement of posteriorlydisplaced fragments on the spinal cord.Neurosurgery is consulted.Which of the following is the best next step in management of this patient?  \n○ A.Administration of oral prednisone○ B.Bladder catheterization○ C.Femoral line placement○ D.Nasogastric tube insertionO E.Orotracheal intubation  \nSubmit  \n只  \nThis patient who fell headfirst into the hockey rink boards now has findings(eg,altered sensation,quadriplegia)consistent with cervical spinalcord trauma.As for any trauma patient,his evaluation should begin with a primary survey.Because he is alert with normal respirations,he doesnot need further airway protection (eg,orotracheal intubation)or mechanical ventilation (Choice E).He is hemodynamically stable and has goodintravenous (IV)access (ie,2 large-bore peripheral IV catheters)for resuscitation.However,gross motor examination shows quadriplegia;therefore,a detailed neurologic examination is performed.  \nNeurologic examination shows absent pinprick(ie,pain)and temperature sensation (ie,spinothalamic tract),as well as bilateral paralysis (ie,lateral corticospinal tract);vibratory sensation (ie,dorsal columns)is preserved.These findings are most consistent with anterior cord syndrome,likely from the posteriorly displaced C5 fragments causing direct spinal cord trauma or anterior spinal artery injury.Anterior cord syndrome andother severe spinal cord injuries can disrupt the autonomic tracts involved in bladder control,leading to acute urinary retention.Therefore,catheterization should be performed to prevent bladder distension and possible injury.  \n(Choice A)Intravenous steroid (ie,methylprednisolone)therapy may be considered in select patients with acute spinal cord injury.However,oralsteroids are not used.In addition,this patient should be NPO until neurosurgical consultation determines whether immediate surgery is indicated  \n(Choice C)Common indications for central venous access(eg,femoral line)include inadequate peripheral venous access,need for  \nhemodynamic monitoring(eg,measurement of central venous pressure),and infusion of peripherally incompatible solutions(eg,vasopressors)This patient has 2 large-bore peripheral IV catheters,is hemodynamically stable,and has none of these indications.  \n(Choice D)Indications for nasogastric tube insertion include gastrointestinal decompression (eg,ileus,bowel obstruction)and administration ofmedications or nutrition(eg,unconsciousness,inability to swallow).This patient has none of these indications.  \n# Educational objective:\n\nIn patients with traumatic spinal cord injury,disruption of the autonomic tracts involved in bladder control can lead to urinary retention.Therefore,catheterization should be performed to prevent bladder distension and possible injury.  \nMedical Library  \nNeuroanatomy:Spinal cord  \nReferences  \nC Incomplete cord syndromes:clinical and imaging review.  \nEmergency Medicine  \nNervous System  \nSpinal cord injury  \nSystem  \nTopic  \nScanned by Camera Scanner  \nExit Mode  \nPrevious  \nTutorial  \ncord traum:Exhibit Displaynot need furintravenoustherefore,aNeurologic elateral corticlikely from thother severecatheterizat(Choice ","cbCaifnIuZloGgSx","https://ap.wps.com/l/cbCaifnIuZloGgSx","pdf",42020030,146,"English","# Primary survey in traumatic spinal cord injury\n## Why bladder catheterization is needed\n## Findings suggesting anterior cord syndrome\n## Why other options are not appropriate","[{\"question\":\"Why is bladder catheterization the best next step for this patient?\",\"answer\":\"Quadriplegia with anterior cord syndrome suggests disruption of autonomic tracts controlling bladder function, leading to acute urinary retention. Catheterization prevents bladder distension and possible injury.\"},{\"question\":\"What key neurologic findings support the diagnosis of anterior cord syndrome?\",\"answer\":\"The patient has absent pinprick and temperature sensation below the clavicles and bilateral paralysis, while vibratory sensation is preserved. This pattern fits anterior spinal cord involvement.\"},{\"question\":\"Does an anxious but breathing-stable patient need immediate orotracheal intubation?\",\"answer\":\"No. With normal respirations and preserved airway status, further airway protection or mechanical ventilation is not indicated at this time.\"}]","Cervical Spinal Cord Trauma: Best Next Step in Management - Urinary Catheterization | PDF",1791583980,368]