Stanton D, Hardcastle T, Muhlbauer D, van Zyl D
Netcare Education, Faculty of Emergency and Critical Care, South Africa.
University of Kwazulu Natal, Trauma Surgery Training Unit, Inkosi Albert Luthuli Central Hospital Trauma Service and Trauma ICU, South Africa.
Afr J Emerg Med. 2017 Mar;7(1):4-8. doi: 10.1016/j.afjem.2017.01.007. Epub 2017 Jan 28.
The consequences of spinal injury as a result of trauma can be devastating. Spinal immobilisation using hard trauma boards and rigid cervical collars has traditionally been the standard response to suspected spinal injury patients even though the risk may be extremely low. Recently, adverse events due to the method of immobilisation have challenged the need for motion restriction in all trauma patients. International guidelines have been published for protection of the spine during transport and this article brings those guidelines into the South African context.
Trauma patients need to be properly assessed using both an approved list of high and low risk factors, as well as a thorough examination. They should then be managed accordingly. Internationally validated assessment strategies have been developed, and should be used as part of the patient assessment. The method of motion restriction should be selected to suit the situation. The use of a vacuum mattress is the preferable technique, with the use of a trauma board being the least desirable.
The need for motion restriction in suspected spinal injury should be properly evaluated and appropriate action taken. Not all trauma patients require spinal motion restriction.
创伤导致的脊柱损伤后果可能是毁灭性的。传统上，对于疑似脊柱损伤患者，使用硬创伤板和硬质颈托进行脊柱固定一直是标准应对措施，即便风险可能极低。近来，因固定方法导致的不良事件对所有创伤患者限制活动的必要性提出了质疑。已发布了关于在转运过程中保护脊柱的国际指南，本文将这些指南引入南非背景。
创伤患者需要使用经批准的高风险和低风险因素清单以及进行全面检查来进行恰当评估。然后应据此进行处理。已制定了国际认可的评估策略，应将其用作患者评估的一部分。应选择适合具体情况的活动限制方法。使用真空床垫是更可取的技术，而使用创伤板是最不可取的。
对于疑似脊柱损伤患者限制活动的必要性应进行恰当评估并采取适当行动。并非所有创伤患者都需要限制脊柱活动。
