Member May 2026: Standardizing Inpatient Care for Pediatric Spinal Cord Injury-Session Recording

Video Transcription

Video Summary

The session reviewed the current state of pediatric spinal cord injury care guidelines, with a focus on what is available for inpatient rehabilitation. Presenters grouped existing guidance into three categories: acute care guidelines, topic-specific adult-focused guidelines from the PVA/Consortium for Spinal Cord Medicine, and pediatric-specific reviews or consensus statements. They noted that most formal guidelines address emergency, ICU, and surgical management, while inpatient rehab care often relies on adapting adult recommendations and local institutional practice.<br /><br />Key gaps identified included uncertainty around when to stop interventions started in acute care, especially for neurogenic bladder, bowel programs, autonomic dysreflexia (AD), VTE prophylaxis, pressure injury prevention, and neurologic assessment in younger children. The group emphasized that there is no comprehensive, up-to-date evidence-based guideline specifically for pediatric inpatient rehab during the subacute phase.<br /><br />The discussion then focused on three major clinical areas: neurogenic bladder, neurogenic bowel, and AD. Speakers shared practical institutional approaches, highlighted variability in catheter removal timing, bowel program methods, and AD response pathways, and stressed the importance of standardized education for families, nurses, and other caregivers. They also discussed the challenges of performing the first ASIA/ISNCSCI exam in children, especially those who are intubated or distressed, and described strategies such as breaking the exam into parts and using communication supports or even ice/cold testing when pinprick is not tolerated.<br /><br />Overall, the session made a call for expert consensus guidelines for pediatric inpatient spinal cord injury rehabilitation to reduce practice variation, support education, and improve care standardization.

Keywords

pediatric spinal cord injury

inpatient rehabilitation

clinical guidelines

acute care

neurogenic bladder

neurogenic bowel

autonomic dysreflexia

ASIA exam

ISNCSCI assessment

pressure injury prevention

VTE prophylaxis