Rethnam Ulfin, Cordell-Smith James, Sinha Amit
Department of Orthopaedics, Glan Clwyd Hospital, Bodelwyddan, UK.
J Trauma Manag Outcomes. 2007 Nov 30;1(1):6. doi: 10.1186/1752-2897-1-6.
Specialisation in spinal services has lead to a low threshold for referral of cervical spine injuries from district general hospitals. We aim to assess the capability of a district general hospital in providing the halo vest device and the expertise available in applying the device for unstable cervical spine injuries prior to transfer to a referral centre.
The study was a postal questionnaire survey of trauma consultants at district general hospitals without on-site spinal units in the United Kingdom. Seventy institutions were selected randomly from an electronic NHS directory. We posed seven questions on the local availability, expertise and training with halo vest application, and transferral policies in patients with spinal trauma.
The response rate was 51/70 (73%). Nineteen of the hospitals (37%) did not stock the halo vest device. Also, one third of the participants (18/51, 35%, 95% confidence interval 22 - 50%) were not confident in application of the halo vest device and resorted to transfer of patients to referral centres without halo immobilization.
The lack of equipment and expertise to apply the halo vest device for unstable cervical spine injuries is highlighted in this study. Training of all trauma surgeons in the application of the halo device would overcome this deficiency.
脊柱服务的专业化导致地区综合医院对颈椎损伤的转诊门槛较低。我们旨在评估一家地区综合医院提供头环背心装置的能力，以及在将不稳定颈椎损伤患者转至转诊中心之前应用该装置的专业知识。
该研究是对英国没有现场脊柱科的地区综合医院的创伤顾问进行的邮寄问卷调查。从英国国家医疗服务体系（NHS）电子名录中随机选取70家机构。我们提出了七个关于头环背心应用的当地可用性、专业知识和培训以及脊柱创伤患者转诊政策的问题。
回复率为51/70（73%）。19家医院（37%）没有储备头环背心装置。此外，三分之一的参与者（18/51，35%，95%置信区间22 - 50%）对头环背心装置的应用缺乏信心，不得不将患者转至转诊中心而不进行头环固定。
本研究突出了在应用头环背心装置治疗不稳定颈椎损伤方面设备和专业知识的缺乏。对所有创伤外科医生进行头环装置应用培训将克服这一不足。
