Member May 2026: Standardizing Inpatient Care for Pediatric Spinal Cord Injury (On-Demand)-Session Recording

Video Transcription

Video Summary

The session introduced a member-led discussion on pediatric inpatient rehab care for spinal cord injury, with a focus on the lack of comprehensive, up-to-date guidelines for the subacute rehab phase. Speakers reviewed three main types of guidance: acute care guidelines (mostly adult-focused trauma/surgical recommendations), topic-specific PVA/Consortium guidelines, and a smaller set of pediatric-specific reviews and consensus statements.<br /><br />The main takeaway was that existing guidelines largely address emergency, ICU, and early surgical management, but do not give enough direction for inpatient rehab decisions such as when to stop a Foley, how long to continue VTE prophylaxis, how to manage pressure injury prevention, or how to interpret neurologic exams in younger children. Because pediatric spinal cord injury is relatively rare, the presenters argued that randomized trials are unrealistic and that expert consensus may be the best path to standardize care.<br /><br />The talk then shifted to three major rehab topics: neurogenic bladder, neurogenic bowel, and autonomic dysreflexia. Presenters shared real-world practice variation across institutions, including timing of Foley removal, bowel program techniques, use of DigStim, and AD action plans. They emphasized the need for clear protocols, family education, and standardized tools. Prognostication and timing of the initial ASIA/ISNCSCI exam were also discussed, especially in nonverbal or medically complex children.<br /><br />Overall, the group called for a collaborative effort to develop consensus-based inpatient rehab guidelines for pediatric spinal cord injury to reduce variation, improve education, and support future research.

Keywords

pediatric spinal cord injury

inpatient rehabilitation

subacute rehab guidelines

consensus-based care

neurogenic bladder

neurogenic bowel

autonomic dysreflexia

ASIA exam

ISNCSCI

pressure injury prevention

venous thromboembolism prophylaxis