Actionable Nuggets (1st ed., 2010)

1. Epidemiology of Spinal Cord Injury
Be aware of the most important health risks for patients with spinal cord injuries

2. Screening for Cardiovascular Risk in SCI
Screen for cardiovascular risk factors at least annually

3. The Importance of Regular Urologic Follow Up
Refer individuals with SCI to urology annually

4. Recognizing Urinary Tract Infections in SCI Patients
Diagnosis of UTI in SCI requires three criteria: (1) significant bacteriuria; (2) pyuria; and (3) signs and symptoms

5. Pharmacological Management of UTI
Prescribe fluorquinolones as first-line treatment for patients with SCI presenting with symptomatic UTI

6. Screening for Bladder Cancer in SCI Patients
Cystoscopy is recommended annually for SCI patients with indwelling catheters

7. Annual Assessment of Neurogenic Bowel
Conduct an annual assessment of bowel function in patients with SCI

8. Constipation in Neurogenic Bowel
Refer spinal cord injured patients with persistent constipation to a registered dietician

9. Periodic Re-evaluation of Bowel Program
Refer individuals with SCI whose bowel care needs have changed due to physiatry for redesign of their bowel care routine

10. Screening for Colorectal Cancer in SCI Patients
Screen patients with SCI for colorectal cancer using same guidelines as general population

11. Assessment of Pain in SCI Patients
Distinguish between neuropathic and nociceptive pain in your patient with SCI

12. Management of Neuropathic Pain
Use a step-wise evidence-based protocol for the management of neuropathic pain in SCI

13. Autonomic Dysreflexia
Signs and symptoms of AD include sudden hypertension, headache, and bradycardia

14. Screening for Depression in SCI
Conduct annual screening for depression in patients with SCI using the PHQ3/9

15. Prevention of Skin Breakdown
Use the Braden scale to access for risk of pressure ulcer development

16. Treatment of Skin Breakdown
Treat stage 1 or 2 wounds with nursing intervention. Treat stage 3 or 4 wounds with specialist surgical intervention

17. Assessment of Cardiovascular Disease Risk Factors in SCI
Recommendations for prevention of CVD developed for non-disabled individuals are applicable to patients with SCI

18. Physical Activity and SCI
Patients with SCI should be encouraged to participate in regular physical activities to improve and maintain health

19. Management of Chronic Upper Extremity Pain
Treatment objectives for chronic upper extremity pain include pain reduction, functional restoration, and alleviation of associated psychosocial distress

20. Sexuality in SCI
Monitor and discuss pre- and post-injury sexual activity, sexual function, and reproductive issues