The need for paramedics to be able to identify cauda equina syndrome
Cauda equina syndrome (CES) is a rare but serious neurological emergency, which may require urgent neurosurgical intervention. If left untreated it can lead to devastating consequences of paraplegia with bladder or bowel sphincter deficits. It is the experience of the authors that this is a condition that pre-hospital clinicians may encounter but does not currently feature in all paramedic education curricula.This article looks at what the cauda equina is and how CES can occur. It describes the common signs and symptoms as well as identifying those which should be considered as red flags in practice.After also considering the medico-legal aspects associated with the incorrect or delayed diagnosis of cauda equina syndrome, the authors will recommend that this condition should feature on the future curriculum of all paramedic education and should be a differential diagnosis, considered whenever a clinician assesses a patient with back pain, especially of a non-traumatic nature.
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