tetraplegia, paralysis of the arms, legs, and trunk of the body below the level of an associated injury to the spinal cord. This disorder is usually caused by spinal cord injury, especially in the area of the fifth to the seventh vertebrae. Automobile accidents and sporting mishaps are common causes. This condition affects about 150,000 Americans, the majority of whom are men between 20 and 40 years of age. Signs and symptoms commonly include flaccidity of the arms and the legs and the loss of power and sensation below the level of the injury. Cardiovascular complications also may develop from any injury that damages the spinal cord above the fifth cervical vertebra because of an associated block of the sympathetic nervous system. A major cause of death from such injury is respiratory failure. Other symptoms may include low body temperature, bradycardia, impaired peristalsis, and autonomic dysreflexia. Diagnosis is based on a complete physical and neurological examination with radiographic pictures of the head, chest, and abdomen to rule out underlying injuries. Spinal x-ray examinations and CT scores and MRI are usually done to evaluate the extent of the injury. Also called quadriplegia. Compare hemiplegia, paraplegia. ▪ INTERVENTIONS: Treatment starts at the accident scene, where the patient’s neck and spine are immobilized. Additional immobilization at the hospital commonly includes the use of halo traction. Steroids may be administered to decrease spinal cord edema. Surgery is commonly performed to fuse unstable spinal sections and remove bone fragments. ▪ PATIENT CARE CONSIDERATIONS: The care of a patient with a spinal cord injury resulting in quadriplegia is complex—mentally, physically, and socially. The prevention of complications requires a coordinated effort. It is essential that the patient, the patient’s family, and an interprofessional rehabilitation team work together to establish short-term and long-term goals.
