Spinal Cord Injury Warning Signs: When to Seek Emergency Care

Red-Flag Symptoms

Category	Signs
Sensory	Numbness, tingling, paresthesias in limbs/trunk; sensory level
Motor	Weakness, paralysis (flaccid initially, then spastic); loss of coordination
Autonomic	Neurogenic shock (hypotension, bradycardia), autonomic dysreflexia (hypertension, bradycardia, flushing), bladder/bowel incontinence or retention, priapism
Pain	Severe neck/back pain; radicular pain
Respiratory	Dyspnea, inability to clear secretions (high cervical injury)
Other	Headache, dizziness, visual changes (if associated head trauma)

Mechanism & Onset

• Traumatic (MVC, fall, violence, sports): sudden onset.
• Non-traumatic (epidural abscess, hematoma, tumor, transverse myelitis): subacute to acute.

Immediate Action

1. Call 911 / activate emergency response.
2. Immobilize cervical spine (rigid collar, log roll).
3. Do not move patient unless imminent danger.
4. Monitor ABCs; prepare for intubation if high cervical injury.

Time Is Spinal Cord

Early decompression (<24 hrs for incomplete injuries) and neuroprotective measures (mean arterial pressure ≥85 mmHg) improve neurologic recovery. Transport to a Level I trauma center with neurosurgical/spinal capabilities.