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Initial stabilization
Time critical priorities
If airway compromise from altered mental status, airway management
If hypotension, hemorrhage and sepsis evaluation
If fever and toxic appearance, sepsis pathway
If severe unremitting pain with autonomic symptoms, emergent secondary causes consideration
Immediate safety checks
If new urinary retention, bladder scan
Post void residual 200 mL or greater
If post void residual 200 mL or greater, urgent cauda equina workup
If saddle anesthesia, urgent cauda equina workup
If progressive bilateral weakness, emergent MRI and spine consultation
If bowel incontinence, emergent MRI and spine consultation
Monitoring and analgesia plan
Pain score and functional goal
Goal walk and perform basic activities
Goal sleep and tolerable pain at rest
Reassessment cadence after analgesia
Neuro exam trend after pain control
Gait reassessment after pain control
Red flags and escalation triggers
Serious pathology screen
Cauda equina syndrome features
Urinary retention
New overflow incontinence
Saddle anesthesia
Progressive bilateral neurologic deficits
Infection features
Fever
Immunocompromise
Intravenous drug use
Recent bacteremia
Spinal procedure within 30 days
Malignancy features
Known cancer
Unexplained weight loss
Night pain
Fracture features
Significant trauma
Minor trauma with osteoporosis
Chronic glucocorticoids
Vascular features
Pulsatile abdominal mass
Hypotension
Syncope
Risk factors for abdominal aortic aneurysm
Key concepts
Working diagnosis framing
Lumbar radiculopathy term alignment
ICD 10 M54.16 radiculopathy lumbar region
ICD 10 M54.17 radiculopathy lumbosacral region
SNOMED CT concept lumbar radiculopathy
Typical mechanism
Nerve root irritation or compression
Most common cause lumbar disc herniation
Natural history
Many cases improve with conservative care
Symptomatic lumbar disc herniation spontaneous improvement reported 60% to 90%
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.