Use serial SCI assessments with a consistent grading tool to monitor and communicate motor and sensory improvement or deterioration, including reflexes, deep tendon function, and rectal tone. Be sure to establish baseline findings and perform serial assessments—usually hourly or more often during the initial injury phase and less often as the injury stabilizes. Conduct additional assessments and document findings each time the patient has been moved out of bed (for instance, for diagnostic tests) or if you suspect deterioration.