Following injury, the body initially goes into a stage of ‘spinal shock’. This is the total loss of all reflex functions and all movement below the level of the lesion, like a ‘blackout effect’. To keep the injured person alive, the care must compensate for the arrest of vital functions such as respiration and the elimination of urine and fecal waste. This condition may last several hours, days or even weeks. It may be difficult to determine the extent of the injury during spinal shock.