Individuals with a spinal cord injury (SCI) will face a number of different challenges. Much depends on the seriousness of the damage and the location where the injury has occurred.
Whilst loss of mobility and sensation are often forefront in people’s minds, there are numerous other issues and secondary health conditions that those with SCIs may have to contend with.
Some of the major issues, particularly for those with injuries higher up the spine in the cervical region, are complications with the respiratory system.
For some, this may mean difficulty breathing unassisted. Even if breathing is not affected, spinal cord injuries can result in an increased risk of infections such as pneumonia.
Here we take a closer look at pneumonia in SCI patients, what this can mean for the individual and how it can be treated and managed.
Pneumonia is one of the most common infections of the respiratory system and it can have a variety of different causes, including viruses, bacteria and even fungi. People with a weakened immune system are often more at risk, which is why it more commonly affects the elderly and babies, compared with the rest of the population.
It’s a condition that can start off feeling like a normal cold but often progresses to more severe symptoms such as a high temperature as well as the production of discolored and even bloody sputum.
Germs that get into the lungs quickly cause an infection that inflames the tissue, causing secretions and fluid to accumulate. If one is unable to expel these fluids because of a weakened immune cough response or loss of motor control, the germs can thrive and spread.
Symptoms of pneumonia include shortness of breath, loss of appetite, confusion, headaches and chest pains. There are a number of risk factors associated with pneumonia including pleurisy which can lead to lung failure and blood poisoning in rare circumstances.
Whilst we often associate pneumonia with individuals who are fairly weak such as babies and the elderly, it is also a potential risk for those with an SCI. This is especially true if the injury to the spinal cord has occurred in the cervical region, as breathing can be impaired, which makes it difficult to cope with an infection such pneumonia.
When a bacterial or viral infection takes hold, the inability to clear the lungs and cough up sputum often means that the condition gets worse.
Respiratory problems, such as pneumonia, are the leading cause of death in spinal cord injury patients, whilst they only account for about 3% of deaths in the general population.
A lot depends on the location of the injury to the spinal cord – the higher up it is, the more the individual is at risk. A cervical spinal cord injury, for example, is highly likely to impact on the effectiveness of the respiratory system as a whole, something which can be a huge influence if someone then contracts pneumonia.
Other factors can be involved. The patient may have reduced immunity following their accident or injury. Their impaired mobility may mean they are likely to have a less robust constitution and may be unable to fight even minor infections. They might be at greater risk of infection in a hospital or rehab environment and there could be more infection issues in using a respiratory device to aid breathing.
Whilst pneumonia in spinal cord injury patients is more likely to occur than within the general population, it doesn’t mean nothing can be done. The trouble with recognizing pneumonia is that it often starts out as a run of the mill infection.
Maintaining a good diet and having flu injections are one way to ensure that an individual reduces the risk of pneumonia. If they are using a respiratory device, making sure it is hygienically clean can help prevent infections.
If there is someone in the family who has a cold or flu, it’s a good idea to ask them not to visit and stay away until they have recovered.
It’s important to be aware of the symptoms such as frequent coughing, a full feeling in the chest, strange rashes and difficulty swallowing. If anything out of the ordinary is noticed, it’s important to go and see a doctor.
If pneumonia does occur, quick treatment is essential. Antibiotics are generally used for bacterial infections.
For someone with a spinal cord injury, admission to a hospital for round the clock monitoring may be necessary, especially if they have a history of respiratory infections. Whilst it’s not always completely necessary, if there are any concerns at all it’s important to have staff on-site who know what treatment to provide and to help monitor the condition of the patient.
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