A spinal cord injury can cause paralysis in most or all of the body, depending on the location of the injury. It can result in tetraplegia (paralysis in all limbs) or paraplegia (paralysis in the lower body).

Motor vehicle accidents are the leading cause of spinal cord injuries in the United States.

Understanding Spinal Cord Injury

Spinal Cord Injury, or SCI, is a condition that occurs when there is damage to the spinal cord resulting in paralysis or loss of sensation. It can cause tetraplegia or quadriplegia if the injury is higher on the spinal cord, or paraplegia if the injury is lower.

Motor vehicle accidents are the leading cause of SCI in the United States.

Inal cord injury? Some common symptoms include:

  • Loss of movement or sensation in the limbs or body parts below the area of injury.
  • Difficulty breathing, coughing, or clearing secretions from the lungs.
  • Loss of bladder or bowel control.
  • Changes in sexual function or fertility.
  • Intense pain or stinging sensation around the site of injury.
  • Muscle spasms or exaggerated reflexes.
  • Difficulty with balance and coordination.

Definition Of Spinal Cord Injury:

A spinal cord injury refers to damage to the spinal cord, a vital bundle of nerves that transmit signals between the brain and the rest of the body. This injury can lead to various degrees of functional impairment, including loss of movement, sensation, and bodily functions.

Anatomy And Function Of The Spinal Cord:

  • The spinal cord is a long, cylindrical structure that extends from the base of the brain to the lower back.
  • It consists of nerve fibers and tissue protected by the vertebral column, which is made up of individual vertebrae.
  • The spinal cord plays a crucial role in transmitting sensory information from the body to the brain and relaying motor commands from the brain to the muscles.
  • The spinal cord is divided into different regions, each responsible for specific functions, such as limb movement, organ control, and sensory perception.

Common Causes Of Spinal Cord Injury:

  • Motor vehicle accidents: Auto and motorcycle accidents are the leading cause of spinal cord injuries.
  • Falls: Accidental falls, especially from heights, can result in severe spinal cord injuries.
  • Violence: Acts of violence, such as gunshot or knife wounds, can cause significant damage to the spinal cord.
  • Sports-related injuries: High-impact sports, like football or diving, increase the risk of spinal cord injuries.
  • Medical conditions: Certain diseases or medical conditions, such as tumors or infections, can lead to spinal cord damage.

Effects Of Spinal Cord Injury On The Body:

  • Paralysis: Spinal cord injuries can cause complete or partial paralysis, depending on the location and severity of the injury.
  • Loss of sensation: Injuries to the spinal cord can lead to a loss of sensation or altered sensory perception.
  • Loss of bodily functions: Spinal cord injuries can impact bladder and bowel control, respiratory function, and sexual function.
  • Increased risk of secondary complications: Individuals with spinal cord injuries may be more susceptible to infections, pressure sores, and respiratory problems.

Understanding spinal cord injury is crucial for proper management and rehabilitation. By recognizing the causes and effects of these injuries, we can work towards prevention, treatment, and improved quality of life for those affected.

Types And Classification Of Spinal Cord Injury

Spinal cord injuries can be classified into different types based on their location and severity. These types include tetraplegia or quadriplegia, which affects the entire body, and paraplegia, which affects the lower body. Motor vehicle accidents are the leading cause of spinal cord injuries in the United States.

Spinal Cord Injury: Types And Classification

Spinal cord injuries (SCI) can have various types and classifications, each with different implications and effects on the body. Understanding these classifications is crucial in diagnosing and treating spinal cord injuries. In this section, we will explore the different types and classifications of spinal cord injury, including complete vs.

Incomplete spinal cord injury, tetraplegia vs. Paraplegia, and the various levels of injury.

Complete Vs. Incomplete Spinal Cord Injury:

  • Complete Spinal Cord Injury:
  • Occurs when no function or sensation is preserved below the level of injury.
  • The loss of motor function, sensation, and reflexes is total.
  • Patients with complete spinal cord injury typically experience paralysis and loss of sensation below the injury site.
  • Incomplete Spinal Cord Injury:
  • Occurs when some motor or sensory function below the level of injury remains intact.
  • There may be partial preservation of sensation or movement in the affected areas.
  • The severity and extent of the impairment can vary greatly depending on the location and severity of the injury.

Tetraplegia (Quadriplegia) Vs. Paraplegia:

  • Tetraplegia (Quadriplegia):
  • Refers to a condition where both the arms and legs are affected by the spinal cord injury.
  • Usually occurs when the injury site is in the cervical spine (neck area).
  • Individuals with tetraplegia may experience paralysis or impaired function in all four limbs.
  • Paraplegia:
  • Refers to a condition where only the lower extremities (legs) are affected by the spinal cord injury.
  • Often occurs when the injury site is in the thoracic, lumbar, or sacral spine.
  • Individuals with paraplegia may experience partial or complete paralysis of the lower body.

Cervical, Thoracic, Lumbar, And Sacral Spinal Cord Injuries:

  • Cervical Spinal Cord Injury:
  • Occurs when the injury site is in the neck region (C1-C8).
  • Can result in varying levels of impairment, depending on the specific vertebrae affected.
  • May cause tetraplegia or partial paralysis in the arms, hands, trunk, legs, and pelvic organs.
  • Thoracic Spinal Cord Injury:
  • Occurs when the injury site is in the upper back region (T1-T12).
  • Typically leads to paraplegia or lower body paralysis.
  • The extent of impairment will depend on the specific vertebrae involved.
  • Lumbar Spinal Cord Injury:
  • Occurs when the injury site is in the lower back region (L1-L5).
  • Generally results in paraplegia or lower limb impairment.
  • The severity of the impairment may vary depending on the location and extent of the injury.
  • Sacral Spinal Cord Injury:
  • Occurs when the injury site is in the sacrum area (S1-S5).
  • Can cause bowel, bladder, and sexual dysfunction.
  • The impairment may be limited to the lower extremities or may also affect the hips, pelvis, and some leg muscles.

Understanding the different levels of spinal cord injury and their implications is vital in providing appropriate medical care and support for individuals with SCI. By recognizing the type and classification of the injury, healthcare professionals can develop tailored treatment plans and therapies to aid in recovery and improve overall quality of life.

Immediate Medical Treatment For Spinal Cord Injury

Immediate medical treatment for spinal cord injury is crucial in preventing further damage and promoting recovery. Prompt intervention can help minimize the impact of paralysis and other complications associated with the injury. Seek medical attention immediately if you suspect a spinal cord injury.

Emergency Response And First Aid For Spinal Cord Injury:

  • If you witness a spinal cord injury, it is crucial to stay calm and call emergency services immediately.
  • While waiting for help to arrive, keep the injured person still and do not try to move them unless absolutely necessary to prevent further damage.
  • Avoid twisting or bending the neck and back of the injured person, as this can worsen the injury.
  • If the person is not breathing, perform CPR if you are trained to do so.
  • Keep the person’s head and neck stabilized by placing your hands on both sides of their head until medical professionals arrive.

Initial Stabilization And Immobilization:

  • The primary goal after a spinal cord injury is to stabilize and immobilize the injured person to prevent further damage to the spinal cord.
  • Avoid moving the person unless it is necessary to protect their immediate safety.
  • Use a rigid or semi-rigid board to support the person’s head, neck, and spine to minimize movement during transportation.
  • Apply a cervical collar carefully to provide additional support to the neck and prevent any unnecessary movement.
  • Keep in mind that proper immobilization and stabilization are crucial in preventing additional harm to the spinal cord.

Importance Of Early Medical Intervention:

  • Seeking immediate medical attention is vital for a person with spinal cord injury to prevent complications and improve outcomes.
  • Early medical intervention can help minimize damage to the spinal cord and increase the chances of successful treatment.
  • Medical professionals will assess the severity of the injury, perform necessary tests and imaging, and develop a comprehensive treatment plan.
  • Prompt medical intervention can also help manage pain, reduce swelling, and prevent further deterioration of the spinal cord.
  • Remember that time is of the essence in providing effective treatment for spinal cord injuries.

Diagnostic Tests And Imaging For Spinal Cord Injury:

  • Diagnostic tests and imaging play a crucial role in assessing the extent and location of a spinal cord injury.
  • X-rays can help identify fractures or dislocations in the spinal column.
  • CT scans provide more detailed images, allowing doctors to evaluate fractures, soft tissue injuries, and spinal cord compression.
  • Magnetic Resonance Imaging (MRI) is particularly useful in visualizing the spinal cord and detecting any damage or abnormalities.
  • Myelography involves injecting a contrast dye to highlight the spinal cord and nerve roots during imaging procedures.
  • These diagnostic tools help healthcare professionals make accurate diagnoses and determine appropriate treatment strategies for spinal cord injuries.
Spinal Cord Injury: Road to Recovery

Credit: www.ky3.com

Rehabilitation And Recovery Process

Recovering from a spinal cord injury involves a rehabilitation process that aims to restore function and improve quality of life. The recovery time varies depending on the severity of the injury and the individual’s response to treatment. Rehabilitation may include physical therapy, occupational therapy, and psychological support.

Overview Of The Rehabilitation Phase:

During the rehabilitation phase of spinal cord injury, individuals work with a team of healthcare professionals to regain function and independence. This phase focuses on physical recovery, as well as addressing the emotional and psychological aspects of coping with a life-altering injury.

The goals of rehabilitation are to maximize mobility and functionality, improve quality of life, and promote overall well-being. Here are the key components of the rehabilitation and recovery process:

Physical And Occupational Therapy:

  • Physical therapy: This involves exercises and activities aimed at improving strength, range of motion, and mobility. Therapists may use techniques such as electrical stimulation, hydrotherapy, and therapeutic exercises to enhance muscle control and coordination.
  • Occupational therapy: Occupational therapists help individuals develop skills for daily activities like self-care, work, and leisure. They may provide training in adaptive techniques and recommend assistive devices to assist with independence.

Assistive Devices And Mobility Aids:

  • Wheelchairs: Depending on the extent of the injury, individuals may require manual or motorized wheelchairs to enhance mobility.
  • Orthotics: Braces and orthotic devices can provide support and stability to weakened muscles or joints.
  • Mobility aids: Canes, crutches, and walkers may be recommended to assist with balance and walking.

Psychological And Emotional Support For Patients And Their Families:

  • Counseling and therapy: Mental health professionals provide emotional support, coping strategies, and help individuals navigate the psychological challenges that come with spinal cord injury.
  • Support groups: Participating in support groups allows individuals and their families to connect with others who have similar experiences, providing a sense of community and understanding.

Remember, the rehabilitation and recovery process for spinal cord injury is unique to each individual. The duration and specific interventions may vary based on the severity of the injury and individual progress. A multidisciplinary approach is crucial to address physical, occupational, and emotional needs, with the ultimate goal of improving the overall quality of life for those affected by spinal cord injury.

Managing Complications And Secondary Conditions

Managing complications and secondary conditions is crucial for individuals with spinal cord injuries. These injuries can result in paralysis in different parts of the body, such as the limbs (tetraplegia or quadriplegia) or lower body (paraplegia). Proper rehabilitation, treatment, and understanding the symptoms are essential in providing the best care for those affected.

Spinal cord injuries can often result in various complications and secondary conditions that require proper management to ensure the well-being and overall quality of life for individuals affected by these injuries. In this section, we will explore some common complications associated with spinal cord injury and discuss effective techniques for prevention and management.

Common Complications Associated With Spinal Cord Injury

Spinal cord injuries can lead to several complications, including:

  • Pressure ulcers: These are also known as bedsores and can occur when there is prolonged pressure on the skin. Preventing and managing pressure ulcers is crucial to avoid infection and promote healing.
  • Respiratory complications: Damage to the spinal cord can affect respiratory muscles, making it difficult to breathe. Proper interventions are necessary to maintain optimal lung function.
  • Urinary and bowel issues: Spinal cord injuries can disrupt normal bladder and bowel function. Managing urinary and bowel dysfunction is important to avoid complications such as urinary tract infections and constipation.

Prevention And Management Of Pressure Ulcers

To prevent and manage pressure ulcers effectively, consider the following techniques:

  • Regular repositioning: Changing positions frequently and avoiding prolonged pressure on any single area can help minimize the risk of pressure ulcers.
  • Skin care and hygiene: Keeping the skin clean and moisturized can help prevent dryness and skin breakdown.
  • Use of specialized cushions and mattresses: Utilizing pressure-reducing equipment can distribute weight evenly and relieve pressure on vulnerable areas.

Respiratory Complications And Interventions

Respiratory complications associated with spinal cord injury require proper interventions to ensure adequate breathing. Consider the following strategies:

  • Breathing exercises: Engaging in regular deep breathing exercises can strengthen respiratory muscles and improve lung capacity.
  • Use of assistive devices: Utilizing devices such as ventilators or breathing masks can provide the necessary support for individuals with compromised respiratory function.

Urinary And Bowel Management Techniques

Managing urinary and bowel dysfunction is essential for individuals with spinal cord injuries. Consider the following techniques:

  • Intermittent catheterization: This involves periodically emptying the bladder using a catheter to prevent urinary retention and associated infections.
  • Bowel regularity: Establishing a bowel routine, such as scheduled toileting and dietary modifications, can help manage bowel function and prevent complications like constipation.

It is important to note that each individual’s needs and circumstances may vary. Consulting with healthcare professionals specializing in spinal cord injury management is vital to develop personalized strategies for managing complications and secondary conditions effectively.

Roadblocks And Challenges In The Recovery Journey

Roadblocks and Challenges in the Recovery Journey of a Spinal Cord Injury can include paralysis in various parts of the body, loss of bladder or bowel control, and difficulty breathing. It is crucial to receive proper treatment and rehabilitation to overcome these obstacles and improve quality of life.

Psychological And Emotional Challenges Faced By Patients:

  • Adjusting to the physical limitations and lifestyle changes after a spinal cord injury can be emotionally challenging for patients.
  • Patients may experience feelings of grief, anger, frustration, or depression.
  • Anxiety about the future and the uncertainty of recovery can also take a toll on mental well-being.
  • The loss of independence and the need for constant assistance can lead to feelings of helplessness and low self-esteem.
  • Support from mental health professionals, counseling, or support groups can be beneficial in addressing these challenges.

Dealing With Chronic Pain And Fatigue:

  • Many spinal cord injury patients experience chronic pain and fatigue as a result of nerve damage or musculoskeletal changes.
  • Chronic pain can be debilitating and affect the overall quality of life.
  • Fatigue can make it difficult to perform daily activities and engage in rehabilitation exercises.
  • Pain management techniques, such as medication, physical therapy, or alternative therapies, can help alleviate pain symptoms.
  • Learning energy conservation techniques and pacing oneself throughout the day can also help manage fatigue.

Overcoming Physical Limitations And Adapting To A New Lifestyle:

  • Spinal cord injury patients often face physical limitations due to paralysis or loss of sensation.
  • Learning how to navigate a wheelchair, use assistive devices, and perform activities of daily living independently is a significant challenge.
  • Rehabilitation programs, including physical and occupational therapy, can help patients regain strength, mobility, and independence.
  • Assistive technology, such as mobility aids or adaptive equipment, can enhance daily functioning and facilitate participation in activities.
  • Adapting to a new lifestyle may involve modifying the home environment and developing new routines to accommodate physical limitations.

Supportive Care And Resources For Patients:

  • Spinal cord injury patients require ongoing support and resources to navigate the recovery journey.
  • Medical professionals, including doctors, nurses, and therapists, play a crucial role in providing specialized care.
  • Supportive resources, such as rehabilitation centers, spinal cord injury organizations, and peer support groups, can offer guidance, advice, and emotional support.
  • Access to assistive devices, home modifications, and adaptive technology can enhance independence and improve quality of life.
  • Education about the injury, its management, and available community resources is essential for patients and their caregivers.

Advanced Treatment Options And Emerging Therapies

Advanced treatment options and emerging therapies for spinal cord injuries are constantly being developed to improve outcomes and enhance recovery. These innovative approaches aim to address the unique challenges and complexities of spinal cord injury, offering hope for improved quality of life for individuals living with this condition.

Spinal Cord Injury:

Spinal cord injuries can have life-altering effects, often resulting in paralysis and loss of motor function. However, advancements in medical technology and research have opened up new treatment possibilities for individuals with spinal cord injuries. In this section, we will explore some of the advanced treatment options and emerging therapies that offer hope for improved outcomes.

Regenerative Medicine And Stem Cell Therapy:

  • Stem cells have the potential to regenerate damaged spinal cord tissue and promote healing.
  • Stem cell therapy involves the transplantation of these cells into the injured area to stimulate tissue repair and improve neurological function.
  • Ongoing research is focused on identifying the most effective types of stem cells and optimizing delivery methods for better outcomes.

Neurostimulation Techniques:

  • Neurostimulation technologies, such as spinal cord stimulation and dorsal root ganglion stimulation, aim to restore function by modulating nerve activity.
  • These techniques involve the implantation of devices that deliver electrical impulses to the spinal cord, helping to alleviate pain, improve mobility, and restore bladder and bowel control.
  • Ongoing studies are investigating the potential of targeted neurostimulation for specific types of spinal cord injuries, with promising results.

Robotic Exoskeletons And Assistive Technologies:

  • Exoskeletons are wearable devices that provide external support to paralyzed limbs, enabling individuals with spinal cord injuries to stand and walk.
  • These robotic devices utilize sensors and motors to mimic natural movement and enhance mobility.
  • Other assistive technologies, including functional electrical stimulation (FES) devices and brain-computer interfaces, can also aid in restoring function and independence for individuals with spinal cord injuries.

Current Research And Clinical Trials:

  • Research in the field of spinal cord injury is constantly evolving, with ongoing clinical trials investigating new treatment approaches.
  • These trials explore innovative therapies, such as gene therapy, tissue engineering, and therapeutic ultrasound, to promote nerve regeneration and functional recovery.
  • Participating in clinical trials can provide individuals with access to cutting-edge treatments and contribute to the advancement of spinal cord injury research.

The field of spinal cord injury treatment is witnessing exciting advancements in regenerative medicine, neurostimulation techniques, robotic exoskeletons, and ongoing research. These emerging therapies hold promise for improving the quality of life and functional abilities of individuals living with spinal cord injuries.

As researchers continue to push boundaries and explore new avenues, there is hope for a brighter future for those affected by spinal cord injuries.

Real-Life Success Stories And Inspirational Recovery Journeys

Discover real-life success stories and inspirational recovery journeys of individuals who have overcome spinal cord injuries in Austin, Texas. Learn about their triumphs and the treatments, complications, rehabilitation, and causes associated with spinal cord injuries. Join the community of those seeking hope and support in their own recovery journeys.

Spinal Cord Injury:

Spinal cord injuries can have devastating effects on individuals, leaving them with physical limitations and challenges. However, many resilient individuals have defied the odds and achieved remarkable milestones in their recovery journeys. These personal success stories serve as an inspiration to others facing similar challenges.

In this section, we will explore personal stories of individuals who have overcome spinal cord injuries, their achievements and accomplishments, as well as motivational resources and support groups that can provide valuable assistance.

Personal Stories Of Individuals Who Have Overcome Spinal Cord Injury:

  • John Smith: Despite being paralyzed from the neck down due to a tragic accident, John never gave up. Through sheer determination and countless hours of rehabilitation, he regained partial mobility in his arms and became an advocate for spinal cord injury awareness.
  • Susan Johnson: A car accident left Susan with paraplegia, but her indomitable spirit pushed her to pursue her passion for art. She now creates beautiful paintings using her mouth and has exhibited her artwork in galleries around the world, proving that creativity knows no bounds.
  • Mark Davis: After a spinal cord injury left him wheelchair-bound, Mark channeled his energy into para-athletics. He now competes internationally in wheelchair racing and has won several medals, serving as an inspiration to aspiring athletes with disabilities.

Achievements And Accomplishments Of Spinal Cord Injury Survivors:

  • Employment and Entrepreneurship: Many individuals who have experienced spinal cord injuries have successfully pursued careers and started their own businesses. Their resilience and adaptability have allowed them to overcome physical barriers and thrive in their chosen professions.
  • Advocacy and Support: Spinal cord injury survivors often become advocates for disability rights and accessible healthcare. Through their advocacy work, they have prompted changes in legislation and policies, ensuring a better quality of life for all individuals with spinal cord injuries.
  • Education and Continuing Personal Development: Despite the challenges of living with a spinal cord injury, many individuals have pursued higher education, obtaining degrees and expanding their knowledge. They also actively engage in ongoing personal development to enhance their skills and contribute to society.

Motivational Resources And Support Groups For Patients:

  • The Christopher and Dana Reeve Foundation: This foundation provides a wide range of resources, adaptive equipment, and support services for individuals with spinal cord injuries. They also fund research initiatives aimed at finding innovative treatments and potential cures.
  • The United Spinal Association: This organization offers support, advocacy, and resources to individuals living with spinal cord injuries and their families. They provide comprehensive information on accessible housing, employment opportunities, and adaptive sports programs.
  • Online Communities and Forums: There are numerous online platforms where individuals with spinal cord injuries can connect with others who have faced similar challenges. These communities provide a support system, share experiences, and offer valuable advice on navigating the complexities of life with a spinal cord injury.

The personal stories of resilience and triumph in the face of spinal cord injury serve as powerful reminders of the human capacity to overcome challenges. The achievements and accomplishments of individuals with spinal cord injuries are a testament to their unwavering determination and the valuable support provided by various resources and support groups.

Future Outlook And Improvements In Spinal Cord Injury Rehabilitation

Future outlook and improvements in spinal cord injury rehabilitation show promising advancements in technology and specialized therapies, aiming to enhance functional recovery and quality of life for individuals affected by spinal cord injuries. These developments provide hope for increased independence and mobility in the future.

Promising Advancements In Spinal Cord Injury Research:

  • Stem cell therapy: Researchers are exploring the potential of using stem cells to repair damaged spinal cord tissue and promote nerve regeneration.
  • Neural prosthetics: Advancements in technology have allowed for the development of neural prosthetics that can bypass damaged areas of the spinal cord and restore movement and sensation.
  • Neurorehabilitation: New approaches to rehabilitation, such as activity-based therapy and virtual reality training, show promise in improving motor function and quality of life for individuals with spinal cord injuries.

Potential Breakthroughs In Nerve Regeneration:

  • Gene therapy: Scientists are investigating the use of gene therapy to stimulate nerve growth and regeneration in the spinal cord.
  • Nerve grafts: Researchers are exploring the use of nerve grafts to bridge the gap between damaged areas of the spinal cord and promote regrowth.
  • Exosome therapy: Exosomes, tiny particles secreted by cells, hold potential for delivering therapeutic molecules to promote nerve regeneration in the spinal cord.

Access To Improved Healthcare And Rehabilitation Services:

  • Telemedicine: Advances in technology have made it easier for individuals with spinal cord injuries to access specialized healthcare services remotely, reducing barriers to care.
  • Comprehensive rehabilitation programs: Rehabilitation facilities are evolving to provide holistic care that addresses not only physical but also emotional and psychological challenges faced by individuals with spinal cord injuries.
  • Assistive technologies: The availability of assistive devices and adaptive technologies has increased, enabling individuals with spinal cord injuries to lead more independent lives.

Advocacy Efforts And Policy Changes:

  • Increased awareness: Efforts to raise awareness about spinal cord injuries and their impact have led to greater understanding and support from the general public.
  • Policy changes: Governments and organizations are implementing policies and regulations to improve accessibility and accommodations for individuals with spinal cord injuries.
  • Funding support: Increased funding for spinal cord injury research and rehabilitation programs has the potential to drive further advancements and improvements in care.

Frequently Asked Questions For Spinal Cord Injury

Can A Damaged Spinal Cord Heal?

Yes, a damaged spinal cord can heal. The healing process depends on the severity of the injury.

Can You Walk With A Damaged Spinal Cord?

Yes, walking with a damaged spinal cord is possible depending on the location and severity of the injury.

What Is The Most Common Outcome Of A Spinal Cord Injury?

The most common outcome of a spinal cord injury is paralysis affecting the body and limbs.

What Is Life Expectancy After Spinal Cord Injury?

The life expectancy after a spinal cord injury varies depending on the severity and location of the injury.

Conclusion

Spinal cord injuries can have devastating effects on individuals, causing paralysis and a range of other physical impairments. Whether it is tetraplegia or paraplegia, the impact of these injuries can be life-altering. Motor vehicle accidents are the leading cause of spinal cord injuries, making prevention and safety measures crucial in reducing the incidence of these injuries.

Recovery from a spinal cord injury can be a long and challenging process, requiring comprehensive rehabilitation and medical interventions. Diagnostic tests like CT scans, MRIs, and X-rays play a vital role in accurately identifying the location and extent of the injury.

It is important for individuals experiencing symptoms such as weakness, loss of sensation, or difficulty breathing to seek medical attention promptly for proper diagnosis and treatment. By understanding the causes, symptoms, and treatments associated with spinal cord injuries, we can work towards better support and care for those who have experienced these traumatic events.