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You have a long transport of a patient who may have sustained a spinal injury. The patient has been stable throughout your transport. During one of your​ reassessments, your patient tells you that he is losing the feeling in his feet and toes and his fingers are tingling. At this point you​ should:

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Immediate reassessment and notification of the receiving facility are required when a patient with a potential spinal injury reports new neurological symptoms such as loss of sensation and tingling. A rapid neurological exam can indicate the severity of the injury, and depending on the symptoms and potential diagnoses, different treatment protocols such as aspirin therapy for stroke may be considered.

Step-by-step explanation:

Assessment and Management of a Patient with Suspected Spinal Injury

When a patient with a potential spinal injury reports a loss of sensation in their feet and toes, and experiences tingling in their fingers, this indicates a possible exacerbation of the spinal injury or a new neurological issue. The patient's previous stability does not rule out the need for immediate reassessment and escalation of care. The symptoms described, such as the loss of sensation and tingling, suggest changes in neurological function that could be due to swelling, a secondary injury, or a progression of the initial spinal injury. It is essential to notify the receiving facility and prepare for potential interventions to address this change in the patient's condition.

The neurological exam is a crucial component of the assessment, enabling the provider to identify sensory and motor deficits. Through neurological assessments such as testing reflexes, sensation to light touch, and muscle strength, the health care provider gains valuable information to guide treatment decisions. In this scenario, the patient should be reevaluated with these focused neurological tests, checking for abnormal findings. Knowledge of the neurological exam and prompt application of the FAST mnemonic (Face, Arms, Speech, Time) is vital in such situations as they can signal the need for urgent care.

If a stroke is suspected, which could present with similar symptoms, the patient should be given aspirin to reduce the risk of blood clots as informed by the standard stroke protocol. However, this decision should be made with caution, taking the potential spinal injury into account, as aspirin can increase the risk of bleeding. The immediate action is to report these findings to the receiving hospital's emergency department team to facilitate swift evaluation and treatment upon arrival.

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