Department of Anaesthesia, Section 4231, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Juliane Maries Vej 10, DK-2100, Copenhagen, Denmark.
Trauma Centre, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Scand J Trauma Resusc Emerg Med. 2019 Jul 22;27(1):70. doi: 10.1186/s13049-019-0647-x.
Spinal immobilisation of blunt trauma victims with potential spinal cord injury is considered standard of care. The traditional management has, however, been increasingly questioned and concerns about harm have been raised. Few studies have described the perspective of the trauma patient regarding the spinal immobilisation. The objective of this study was therefore to evaluate the patient experience of immobilisation after trauma.
We prospectively screened adult trauma patients admitted to a level 1 trauma centre for eligibility. We included adult trauma patients who had been, and remembered being, immobilised for spinal protection with a cervical collar and a spine board prehospitally or upon arrival at the trauma centre. A semi-structured interview was conducted 2 to 72 h after admission either in person or by telephone.
One hundred and fourteen patients were eligible for inclusion based on the patient charts. Out of 98 patients assessed for participation, 48 (49%) had no memory of being immobilised. We thus included 50 patients with a median age of 37 years (IQR: 26-60) of whom 38 (76%) were men. The median injury severity score was 9 (IQR: 3-15) and the median time with a cervical collar from initial application to in-hospital removal or until the interview was given was 91 min (IQR: 72-136). Nineteen patients (38%) reported discomfort and 12 patients (24%) experienced pain related to the immobilisation. Forty patients (80%) reported a sense of protection related to the immobilisation.
Discomfort related to spinal immobilisation was reported in 38% of trauma patients. However, a sense of protection was a recurring theme in 80% of the trauma patients, who recalled being immobilised. Nearly half of the awake trauma patients had no memory of being immobilised.
对于有潜在脊髓损伤的钝性创伤患者，脊柱固定被认为是标准的治疗方法。然而，传统的治疗方法受到了越来越多的质疑，人们对其危害提出了担忧。很少有研究描述过创伤患者对脊柱固定的看法。因此，本研究旨在评估创伤后患者对固定的体验。
我们前瞻性地筛选了 1 级创伤中心收治的成年创伤患者，以确定其是否符合入选标准。我们纳入了在院前或到达创伤中心时，因脊柱保护而使用颈托和脊柱板固定过脊柱且记得被固定的成年创伤患者。在入院后 2 至 72 小时，通过面对面或电话进行半结构化访谈。
根据患者病历，有 114 名患者符合入选标准。在评估参与情况的 98 名患者中，有 48 名（49%）没有被固定的记忆。因此，我们纳入了 50 名患者，其年龄中位数为 37 岁（IQR：26-60），其中 38 名（76%）为男性。损伤严重程度评分中位数为 9 分（IQR：3-15），从初始应用到院内去除或进行访谈时，颈托的中位数佩戴时间为 91 分钟（IQR：72-136）。19 名患者（38%）报告不适，12 名患者（24%）报告与固定相关的疼痛。40 名患者（80%）报告对固定有保护感。
38%的创伤患者报告与脊柱固定相关的不适。然而，80%的创伤患者反复提到对固定的保护感，他们记得自己被固定过。近一半清醒的创伤患者没有被固定的记忆。
