The notion that tenderness is quantifiable on a score without trusting the patient is crazy. When you know this patient is fine, can we help you [the doctor] have the courage to not order a test, and, in fact, simply by doing that we found we could get people to do half or a third or a fifth of the studies [c-spine imaging] that they already did. The best decision instruments let us do what we know is right. And they were the five that we already knew were important.
CopyrightMary Ann Liebert, Inc.
This article has been cited by other articles in PMC. Abstract The cervical collar has been routinely used for trauma patients for more than 30 years and is a hallmark of state-of-the-art prehospital trauma care. However, the existing evidence for this practice is limited: Randomized, controlled trials are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability.
Even more concerning, there is a growing body of evidence and opinion against the use of collars.
It has been argued that collars cause more harm than good, and that we should simply stop using them. In this critical review, we discuss the pros and cons of collar use in trauma patients and reflect on how we can move our clinical practice forward.
Conclusively, we propose a safe, effective strategy for prehospital spinal immobilization that does not include routine use of collars. The recommended practice of routine application of collars in trauma patients has largely been unchanged for more than 30 years. Randomized, controlled trials RCTs are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability.
Methods We performed a literature search in the Medline database using a combination of relevant medical subject headings MeSHs and text words: This search was limited to human studies in English available by April All authors contributed to the search strategy development.
We found publications, of which 88 titles were considered relevant by one or two independent authors T. Borderline titles were included.
These publications underwent full review by the author group, and 50 articles were found relevant to prehospital use of collars in trauma patients by more than one author.
These articles are included here. Finally, we searched the reference lists of retrieved articles and contacted experts in the field to identify pertinent studies. Articles published over the last 10—15 years were prioritized. Over the past 40 years, there has been a shift in functional outcome for patients with SCIs in Western countries: The percentage of incomplete tetraplegia has increased, whereas complete paraplegia or tetraplegia has decreased.
Looking Outside the Guidelines CSIs are feared because of the inherent risk of permanent SCI with potential life-threatening and -changing consequences for patients. Collars have essentially become a symbol of high-quality trauma care, and in many EMS systems protocolized paramedics never deliver patients without a collar to the emergency department ED.
Besides, the ABCs of major trauma is a powerful mnemonic and a strong psychological premise for medical action in the field.
Finally, and essential in this regard, it is better to have a protocol than no protocol, and it is better and cheaper to advocate an easy, uniform practice than a difficult, individualized one.
How Effective Are Cervical Collars?Traumatic spinal cord injury is a long-term health and socio-economic burden worldwide. According to the World Health Organisation (WHO), there are , new cases of traumatic spinal cord injury each year. As nearly half of spinal cord injuries occur to people under the age of 35 the lifetime cost of living with spinal cord injury is.
Trauma imagaing Question 1 A patient is brought to the hospital following an ATLS assessment after a horse riding incident. a) Discuss the role of ATLS during the “golden hour”, its impact on the patient care pathway, and the concept of trimodal distribution of death.
(10marks). b) When the patient arrives in the emergency department . Spinal Cord Injury Essay Words | 4 Pages. Spinal Cord Injury Spinal cord injury is a serious problem that effects close to , people in the United .
Free Essay: Trauma C-Spine This essay is not intended to criticize any emergency medical or hospital staff. I am writing this essay out of concern for. Mar 15, · Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review missed CSI presenting with a neurological deficit occurred in less than 1 of spine injury cases and 1 of trauma cases, One of the best validated algorithms is the Canadian C-spine Rule (CCR).
Essays in Health Sciences and Medicine (Name) (University) (Course) (Tutor) Part one Cervical spine injury is defined as a post traumatic injury to the cervical spine that results in .