This episode of the Trauma and Burn Anesthesia Series explores the acute management of spinal cord injury, from mechanisms like motor vehicle accidents and falls to the growing impact on older adults. Key topics include early recognition, imaging strategies, spinal precautions, maintaining supranormal mean arterial pressure for cord perfusion, and the use of methylprednisolone to reduce inflammation. We break down injury types—including Brown-Séquard, anterior, posterior, and central cord syndromes—along with crucial anesthesia pearls for airway management and safe patient transfer. The episode also highlights complications like neurogenic shock and autonomic dysreflexia, detailing when succinylcholine can be used safely and practical steps for treating hypertensive crises in chronic cord injuries.

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