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Cord Compression Admission Orders

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Cord Compression Admission Orders:

  1. General Admission Orders (NEUROLOGY GENERAL ADMISSION MSH IP)

  2. Immobilize neck if trauma suspected

  3. Admit to floor/NSICU

  4. Start steroids w/ likely cord compression without delay (avoid if suspect infection)

    1. Dexamethasone 10mg, then 4 Q6H IV (tumor)

  5. Other Labs: ESR, CRP, WBC and diff, bld clx

  6. Consider diagnostic tests: MRI best (Focused C- or T-spine MRI much better than spine survey, do w/ contrast when tumor/infection suspected), also consider CT w/ contrast (CT will provide you with a lot of information about the bony structures and you may see canal narrowing which may allow you to assume cord compromise); consider CT myelogram

  7. Consider need for straight cath (urinary retention)

  8. Consider soft v hard collar

  9. Neurosurgery consult, consider heme/onc consult and XRT