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院前脊柱固定:脊柱活动限制与脊柱固定的神经学结局

Pre-Hospital Spinal Immobilization: Neurological Outcomes for Spinal Motion Restriction Versus Spinal Immobilization.

作者信息

Nilhas Aaron, Helmer Stephen D, Drake Rachel M, Reyes Jared, Morriss Megan, Haan James M

机构信息

Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS.

Department of Trauma Services, Ascension Via Christi Hospital Saint Francis, Wichita, KS.

出版信息

Kans J Med. 2022 Apr 29;15(1):119-122. doi: 10.17161/kjm.vol15.16213. eCollection 2022.

DOI:10.17161/kjm.vol15.16213
PMID:35646249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9110048/
Abstract

INTRODUCTION

New recommendations for emergency medical services spinal precautions limit long spinal board use to extrication purposes only and are to be removed immediately. Outcomes for spinal motion restriction against spinal immobilization were studied.

METHODS

A retrospective chart review of trauma patients was conducted over a six-month period at a level I trauma center. Injury severity details and neurologic assessments were collected on 277 patients.

RESULTS

Upon arrival, 25 (9.0%) patients had a spine board in place. Patients placed on spine boards were more likely to be moderately or severely injured [injury severity score (ISS) > 15: 36.0% vs. 9.9%, p = 0.001] and more likely to have neurological deficits documented by emergency medical services (EMS; 30.4% vs. 8.8%, p = 0.01) and the trauma team (29.2% vs. 10.9%, p = 0.02).

CONCLUSIONS

This study suggested that the long spine board was being used properly for more critically injured patients. Further research is needed to compare neurological outcomes using a larger sample size and more consistent documentation.

摘要

引言

紧急医疗服务脊柱防护的新建议将长脊柱板的使用限制在仅用于解救目的,并且应立即移除。对脊柱活动限制与脊柱固定的结果进行了研究。

方法

在一家一级创伤中心对创伤患者进行了为期六个月的回顾性病历审查。收集了277例患者的损伤严重程度细节和神经学评估。

结果

到达时,25例(9.0%)患者使用了脊柱板。使用脊柱板的患者更有可能受到中度或重度损伤[损伤严重程度评分(ISS)>15:36.0%对9.9%,p = 0.001],并且更有可能有紧急医疗服务(EMS;30.4%对8.8%,p = 0.01)和创伤团队记录的神经功能缺损(29.2%对10.9%,p = 0.02)。

结论

本研究表明,长脊柱板正被正确用于伤势更严重的患者。需要进一步研究以使用更大样本量和更一致的记录来比较神经学结果。

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Removal of the Long Spine Board From Clinical Practice: A Historical Perspective.从临床实践中移除长脊板:历史视角。
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Patients Immobilized with a Long Spine Board Rarely Have Unstable Thoracolumbar Injuries.使用长脊柱板固定的患者很少发生不稳定的胸腰椎损伤。
Prehosp Emerg Care. 2016;20(2):266-72. doi: 10.3109/10903127.2015.1086845.
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Characteristics of Trauma Patients With Potential Cervical Spine Injuries Underimmobilized by Prehospital Providers.院前急救人员固定不充分的潜在颈椎损伤创伤患者的特征。
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Outcome of trauma patients immobilized by emergency department staff, but not by emergency medical services providers: a quality assurance initiative.由急诊科工作人员而非紧急医疗服务提供者固定创伤患者的结果:一项质量保证举措。
Prehosp Emerg Care. 2014 Oct-Dec;18(4):544-9. doi: 10.3109/10903127.2014.912702. Epub 2014 May 30.
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