Kang Daniel G, Lehman Ronald A
Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, Washington, DC 20307, USA.
J Surg Orthop Adv. 2011 Spring;20(1):2-7.
Care of the combat casualty with spinal column or spinal cord injury has not been previously described, particularly in regards to spinal immobilization. The ultimate goal of spinal immobilization in the combat casualty is to first ``do no further harm'' and then provide a stable, painless spine and an optimal neurologic recovery. The protocol for treatment of the combat casualty with suspected spinal column or spinal cord injury from the battlefield to final arrival at a definitive treatment center is discussed, and the special considerations for medical evacuation off the battlefield and for aeromedical transport are delineated. Selective prehospital spine immobilization, which involves spinal immobilization with backboard, semi-rigid cervical collar, lateral supports, and straps or tape, is recommended if there is suspicion of spinal column or spinal cord injury in the combat casualty and when conditions and resources permit. The authors do not recommend spinal immobilization for the combat casualty with isolated penetrating trauma.
此前尚未描述过对脊柱或脊髓损伤的战斗伤员的护理，特别是在脊柱固定方面。对战斗伤员进行脊柱固定的最终目标首先是“不造成进一步伤害”，然后提供一个稳定、无痛的脊柱并实现最佳的神经功能恢复。本文讨论了从战场到最终到达确定性治疗中心对疑似脊柱或脊髓损伤的战斗伤员的治疗方案，并阐述了战场医疗后送和空中医疗运输的特殊注意事项。如果怀疑战斗伤员有脊柱或脊髓损伤且条件和资源允许，建议采用选择性院前脊柱固定，即使用背板、半刚性颈托、侧向支撑物以及绑带或胶带进行脊柱固定。作者不建议对单纯穿透性创伤的战斗伤员进行脊柱固定。
