The first 24 hours after any traumatic injury are acknowledged as the most critical for
survival, requiring prompt recognition, early evaluation and appropriate management in a
suitable setting [13,14] to achieve best outcomes. Expert consensus [15] recommends
expeditious transfer of the suspected TSCI patient (within 24 hours of injury) to a specialised
spinal cord injury unit (SCIU) equipped to provide comprehensive, state-of-the-art care by an
expert interdisciplinary team. Expeditious transfer enables more rapid diagnosis and
intervention with time-critical neurosurgical procedures [16-18] and emerging pharmacologic
therapies [19] that can enhance preservation (neuroprotection) and possible recovery of
neurological function, as well as prevent secondary complications. Delays in reaching
specialist care are known to increase the occurrence of complications such as avoidable
pressure injuries, urinary tract infections, respiratory problems and contractures; potentially
increasing morbidity and length of stay, delaying or impeding rehabilitation, and adversely
The first 24 hours after any traumatic injury are acknowledged as the most critical for
survival, requiring prompt recognition, early evaluation and appropriate management in a
suitable setting [13,14] to achieve best outcomes. Expert consensus [15] recommends
expeditious transfer of the suspected TSCI patient (within 24 hours of injury) to a specialised
spinal cord injury unit (SCIU) equipped to provide comprehensive, state-of-the-art care by an
expert interdisciplinary team. Expeditious transfer enables more rapid diagnosis and
intervention with time-critical neurosurgical procedures [16-18] and emerging pharmacologic
therapies [19] that can enhance preservation (neuroprotection) and possible recovery of
neurological function, as well as prevent secondary complications. Delays in reaching
specialist care are known to increase the occurrence of complications such as avoidable
pressure injuries, urinary tract infections, respiratory problems and contractures; potentially
increasing morbidity and length of stay, delaying or impeding rehabilitation, and adversely
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