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Spinal Cord Emergencies: False Reassurance from Reflexes
Author(s) -
Glick Thomas H.,
Workman TOM P.,
Gaufberg Slava V.
Publication year - 1998
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1998.tb02787.x
Subject(s) - medicine , medical emergency , service (business) , intensive care medicine , reflex , anesthesia , economy , economics
Summary Emergency physicians need to understand the potential for false reassurance in the interpretation of reflex examination data. Neurologic consultation should be sought when classic signs are lacking, but other evidence causes suspicion. Changes in teaching emphasis and acute practice are needed, since the stakes may be high and time is of the essence. We have responded to the insights gained from this study by augmenting in‐service and continuing medical education teaching and by implementing guidelines to assist EPs. We have emphasized the importance of spotlighting high‐risk patients, as exemplified above, and of taking advantage of neurologic or neurosurgical consultation. Where in‐person consultation is less available, the use of guidelines and remote consultation should be able to help direct further examination, diagnostic formulation, and the need for imaging decisions. Given the potential for severe negative outcome if spinal emergencies are not optimally managed, we must give the teaching of these issues high priority.