Tetraplegia – C3-C4 Spinal Injury

During the Surgical Intensive Care Unit (SICU) single day posting, the chief showed an unfortunate case of a 25-year-old foreign worker who had suffered a “fall from height”, landing on his head, sustaining a severe neck injury.

His diaphragm was paralysed and he lives only because of the accessory muscles of breathing (e.g. trapezius) that are innervated by cranial nerves. He can’t move at all below the neck, he can’t speak, he blows through a tube to indicate when he requires help. Due to the laxity of the intercostal muscles and diaphragm, breathing is difficult and inefficient. Due to the paralysis of his abdominal muscles, he is unable to exhale properly.

Chances of recovery are next to none. His medical bills (the SICU is very expensive) are covered by compensation only as long as he remains in Singapore, while his family remains overseas.

His life is over. Would it have been better for him to have died on the spot?

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