Emergency Department, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
Department of Anesthesiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
Scand J Trauma Resusc Emerg Med. 2019 Aug 19;27(1):77. doi: 10.1186/s13049-019-0655-x.
Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard backboard has been considered to be the most appropriate procedure to prevent secondary spinal cord injuries during patient transportation. However, the procedure has been questioned in recent years, due to the lack of high-quality studies supporting its efficacy. A national interdisciplinary task force was therefore established to provide updated clinical guidelines on prehospital procedures for spinal stabilisation of adult trauma patients in Denmark. The guidelines are based on a systematic review of the literature and grading of the evidence, in addition to a standardised consensus process.This process yielded five main recommendations:A strong recommendation against spinal stabilisation of patients with isolated penetrating trauma; a weak recommendation against the prehospital use of a rigid cervical collar and a hard backboard for ABCDE-stable patients; and a weak recommendation for the use of a vacuum mattress for patient transportation. Finally, our group recommends the use of our clinical algorithm to ensure good clinical practice.
外伤性脊髓损伤在丹麦较为少见，但可能导致严重的神经后果。数十年来，在院前使用硬质颈托和硬板固定颈椎被认为是预防患者转运过程中继发性脊髓损伤的最恰当方法。然而，由于缺乏高质量的研究支持其疗效，该方法近年来受到质疑。因此，成立了一个全国性的跨学科工作组，为丹麦成年创伤患者的院前脊柱稳定提供更新的临床指南。该指南基于文献系统回顾和证据分级，此外还进行了标准化的共识过程。该过程产生了五项主要建议：强烈建议不对单纯穿透性创伤患者进行脊柱稳定；弱建议不院前使用硬质颈托和硬板固定 ABCDE 稳定患者；弱建议使用真空床垫进行患者转运。最后，我们的小组建议使用我们的临床算法来确保良好的临床实践。
