Arishita G I, Vayer J S, Bellamy R F
Department of Military Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799.
J Trauma. 1989 Mar;29(3):332-7. doi: 10.1097/00005373-198903000-00009.
Current guidelines concerning trauma suggest that cervical spine immobilization be performed on all patients with penetrating wounds of the neck. This study was undertaken to examine the risks and benefits likely to be found when such care is provided in a hazardous environment, such as the battlefield, or the scene of a terrorist attack or domestic criminal action. Data for casualties from the Vietnam conflict were reviewed to determine the potential benefit of cervical spine immobilization on the battlefield. In this population, penetrating cervical cord injury was always fatal and usually immediately so. Only 1.4% of all casualties who were candidates for immobilization might have benefitted from the care. However, the risk of performing immobilization in a hazardous environment is substantial since about 10% of casualties are incurred while helping other casualties. Mandatory immobilization of all casualties with penetrating neck wounds sustained in an environment hazardous to first aid providers has an unfavorable risk/benefit ratio.
当前关于创伤的指南建议，对所有颈部有穿透伤的患者进行颈椎固定。本研究旨在探讨在诸如战场、恐怖袭击现场或国内犯罪现场等危险环境中提供此类护理时可能发现的风险和益处。回顾了越南冲突中伤亡人员的数据，以确定在战场上进行颈椎固定的潜在益处。在这一人群中，颈椎穿透伤总是致命的，而且通常是立即致命。所有适合进行固定的伤亡人员中，只有1.4%可能从这种护理中受益。然而，在危险环境中进行固定的风险很大，因为约10%的伤亡是在救助其他伤员时发生的。对在对急救人员有危险的环境中颈部遭受穿透伤的所有伤亡人员进行强制固定，其风险/效益比不利。
