Case 12: Mrs. AJ

We would like to graciously acknowledge Karen Campbell, RN PhD for her contribution to the development of this case study.

Mrs. AJ is an 84-year-old widowed female with a T3, anterior cord spinal injury (SCI), severity C on the ASIA Impairment scale. Mrs. AJ was in her driveway shoveling snow when she slipped and fell on some ice. Mrs. AJ was not able to get up from the ground and was found lying there by a neighbour who was coming home from work and noticed her on the ground. An ambulance was called. Initially, it was thought that Mrs. AJ had most likely fractured her hip until further testing in the ER department confirmed a SCI. She was found to have a T3, anterior cord spinal injury, severity AIS C. Figure 1 shows her health status. Prior to her fall Mrs. AJ was depressed over the death of her husband 1 yr prior. She has not been sleeping or eating well and had lost 65 lbs over the last year. Her current weight is 104lbs down from 169lbs; her height is 5 ft 1in. She had been feeling weak for quite some time, and has been lying down a lot. Her family feels this may have been the cause for her slipping on the ice. She was told by her family doctor that her blood pressure was low, she has thyroid disease and she was anemic.

Figure 1. Mrs. A.J.’s presenting condition.

Figure 2. T3 AIS anterior spinal cord injury, From Medical Illustration © 2010 Nucleus Medical Media, Inc.

Figure 3. Standard neurological classification of spinal cord injury.