From the Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany.
Pediatric Emergency Department, Karlsruhe City Clinic, Karlsruhe.
Pediatr Emerg Care. 2022 Jan 1;38(1):e75-e84. doi: 10.1097/PEC.0000000000002151.
The purpose of this study was to (i) develop a protocol that supports decision making for prehospital spinal immobilization in pediatric trauma patients based on evidence from current scientific literature and (ii) perform an applicability test on emergency medicine personnel.
A structured search of the literature published between 1980 and 2019 was performed in MEDLINE using PubMed. Based on this literature search, a new Emergency Medicine Spinal Immobilization Protocol for pediatric trauma patients (E.M.S. IMMO Protocol Pediatric) was developed. Parameters found in the literature, such as trauma mechanism and clinical findings that accounted for a high probability of spinal injury, were included in the protocol. An applicability test was administered to German emergency medicine personnel using a questionnaire with case examples to assess correct decision making according to the protocol.
The E.M.S. IMMO Protocol Pediatric was developed based on evidence from published literature. In the applicability test involving 44 emergency medicine providers revealed that 82.9% of participants chose the correct type of immobilization based on the protocol. A total of 97.8% evaluated the E.M.S. IMMO Protocol Pediatric as helpful.
Based on the current literature, the E.M.S. IMMO Protocol Pediatric was developed in accordance with established procedures used in trauma care. The decision regarding immobilization is made on based on the cardiopulmonary status of the patient, and life-threatening injuries are treated with priority. If the patient presents in stable condition, the necessity for full immobilization is assessed based upon the mechanisms of injury, assessment of impairment, and clinical examination.
本研究的目的是：(i) 基于当前科学文献中的证据，制定一个支持院前脊柱固定在儿科创伤患者中决策的方案；(ii) 对急诊医学人员进行适用性测试。
在 MEDLINE 中使用 PubMed 对 1980 年至 2019 年间发表的文献进行了结构化搜索。基于该文献搜索，制定了一种新的用于儿科创伤患者的急诊医学脊柱固定方案（E.M.S. IMMO 方案儿科）。方案中纳入了文献中发现的参数，如创伤机制和临床发现，这些参数表明存在高度脊柱损伤的可能性。使用带有案例示例的问卷对德国急诊医学人员进行了适用性测试，以根据方案评估正确的决策。
E.M.S. IMMO 方案儿科是基于已发表文献中的证据制定的。在涉及 44 名急诊医学提供者的适用性测试中，82.9%的参与者根据方案选择了正确的固定类型。共有 97.8%的人认为 E.M.S. IMMO 方案儿科有帮助。
根据当前文献，E.M.S. IMMO 方案儿科是根据创伤护理中使用的既定程序制定的。固定的决策是基于患者的心肺状况做出的，危及生命的损伤是优先治疗的。如果患者处于稳定状态，则根据损伤机制、损伤评估和临床检查评估是否需要完全固定。
