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The Prehospital Management of Suspected Spinal Cord Injury: An Update

Published online by Cambridge University Press:  21 July 2014

Ala'a O. Oteir ,
Karen Smith ,
Paul A. Jennings  and
Johannes U. Stoelwinder
Ala'a O. Oteir*
Affiliation:
Department of Community Emergency Health and Paramedic Practice, Monash University Melbourne, Victoria, Australia
Karen Smith
Affiliation:
Ambulance Victoria, Melbourne, Victoria, Australia Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Department of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia
Paul A. Jennings
Affiliation:
Department of Community Emergency Health and Paramedic Practice, Monash University Melbourne, Victoria, Australia Ambulance Victoria, Melbourne, Victoria, Australia
Johannes U. Stoelwinder
Affiliation:
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
*
Correspondence: Ala'a O. Oteir, BPT, MS EHS Department of Community Emergency Health and Paramedic Practice School of Primary Health Monash University L5, The Alfred Centre, 99 Commercial Road Melbourne, VIC 3004, Australia E-mail alaa.oteir@monash.edu
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Abstract

Introduction

Spinal cord injury (SCI) is a serious condition that may lead to long-term disabilities placing financial and social burden on patients and their families, as well as their communities. Spinal immobilization has been considered the standard prehospital care for suspected SCI patients. However, there is a lack of consensus on its beneficial impact on patients’ outcome.

Objective

This paper reviews the current literature on the epidemiology of traumatic SCI and the practice of prehospital spinal immobilization.

Design

A search of literature was undertaken utilizing the online databases Ovid Medline, PubMed, CINAHL, and the Cochrane Library. The search included English language publications from January 2000 through November 2012.

Results

The reported annual incidence of SCI ranges from 12.7 to 52.2 per 1 million and occurs more commonly among males than females. Motor vehicle collisions (MVCs) are the major reported causes of traumatic SCI among young and middle-aged patients, and falls are the major reported causes among patients older than 55. There is little evidence regarding the relationship between prehospital spinal immobilization and patient neurological outcomes. However, early patient transfer (8-24 hours) to spinal care units and effective resuscitation have been demonstrated to lead to better neurological outcomes.

Conclusion

This review reaffirms the need for further research to validate the advantages, disadvantages, and the effects of spinal immobilization on patients’ neurological outcomes.

OteirAO , SmithK , JenningsPA , StoelwinderJU . The Prehospital Management of Suspected Spinal Cord Injury: An Update. Prehosp Disaster Med. 2014;29(4):1-4.

Keywords

Emergency Medical Servicesepidemiologyimmobilizationprehospital carespinal cord injuries
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 4 , August 2014 , pp. 399 - 402
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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