Kreinest M, Scholz M, Trafford P
Department for Trauma Surgery, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Department for Orthopedics and Anesthesia, Specialty Hospital Vogelsang-Gommern, Sophie-v.-Boetticher-Straße 1, 39245, Gommern, Germany.
Eur J Trauma Emerg Surg. 2017 Apr;43(2):191-200. doi: 10.1007/s00068-016-0749-3. Epub 2016 Dec 22.
Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated. If a competitor must first be extricated from the racing vehicle, the correct method of extrication must be chosen. To avoid secondary injury to the spine after a racing accident, in-line extrication from the vehicle and immobilization of the patient are standard procedures in motor sports and have been used for decades. Since immobilization can be associated with disadvantages and complications, the need for immobilization of trauma patients outside of motor sports medicine has become the subject of an increasing number of reports in the scientific literature. Even in motor sports, where specific safety systems that offer spinal protection are present, the indications for spinal immobilization need to be carefully considered rather than being blindly adopted as a matter of course. The aim of this article is to use recent literature to present an overview about the treatment of spinal injuries in motor sports. Further, we present a new protocol for indications for immobilizing the spine in motor sports that is based on the ABCDE principles and takes into account the condition of the patient.
由于脊髓损伤可能会给受伤的赛车手带来致命后果，因此院前脊髓损伤治疗是赛车运动中的一个主要关注点。评估创伤患者及其治疗的结构化程序应遵循既定的ABCDE原则。只有这样，才能对病情稳定的患者进行进一步检查并采取适当措施。对于处于急性危及生命状况的患者，必须立即开始快速转运，不应因未指明的措施而延迟。如果必须首先将一名参赛者从赛车上解救出来，必须选择正确的解救方法。为避免赛车事故后脊柱受到二次损伤，在赛车上进行直线解救并固定患者是赛车运动中的标准程序，并且已经使用了数十年。由于固定可能会带来不利因素和并发症，在运动医学之外，创伤患者固定的必要性已成为科学文献中越来越多报告的主题。即使在存在提供脊柱保护的特定安全系统的赛车运动中，也需要仔细考虑脊柱固定的指征，而不是盲目地将其作为理所当然的事情。本文的目的是利用近期文献对赛车运动中脊髓损伤的治疗进行概述。此外，我们提出了一种基于ABCDE原则并考虑患者状况的赛车运动中脊柱固定指征的新方案。
