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[Development and first application testing of a new protocol for preclinical spinal immobilization in children :
Philip C Nolte1, Davut D Uzun1, Shiyao Liao1,2
1Klinik für Unfallchirurgie und Orthopädie, BG Klinik Ludwigshafen, 67071, Ludwigshafen, Deutschland.
Insights
A new protocol for pediatric spinal immobilization in emergencies was developed. This E.M.S. IMMO Protocol Pediatric improves decision-making accuracy for emergency medical providers, ensuring better patient care.
Area of Science:
- Emergency Medicine
- Pediatric Trauma Care
- Spinal Injury Management
Background:
- Standard prehospital spinal immobilization protocols primarily focus on adults, potentially inadequately addressing pediatric trauma.
- Pediatric trauma mechanisms and injury patterns differ significantly from adults, necessitating specialized guidelines.
- Current prehospital protocols for pediatric spinal injuries are lacking.
Purpose of the Study:
- To develop a decision-support protocol for prehospital spinal immobilization in pediatric trauma patients.
- To evaluate the effectiveness of the developed protocol in improving emergency personnel's decision-making accuracy.
Main Methods:
- A structured literature search informed the development of the E.M.S. IMMO Protocol Pediatric.
- A questionnaire with four case scenarios assessed decision-making quality.
- Emergency medical providers made immobilization decisions with and without the protocol.
Main Results:
- The E.M.S. IMMO Protocol Pediatric was developed based on scientific literature.
- 39 emergency medicine providers participated in the quality analysis.
- Use of the protocol led to more frequent correct immobilization decisions.
- 38 out of 39 participants found the protocol helpful.
Conclusions:
- The E.M.S. IMMO Protocol Pediatric aids in determining the need for pediatric spine immobilization, considering cardiopulmonary status.
- Initial analysis indicates the protocol enhances decision-making for emergency medical providers in pediatric trauma cases.
Background:
To protect the spine from secondary damage, spinal immobilization is a standard procedure in prehospital trauma management. Immobilization protocols aim to support emergency medicine personnel in quick decision making but predominantly focus on the adult spine; however, trauma mechanisms and injury patterns in adults differ from those in children and applying adult prehospital immobilization protocols to pediatric patients may be insufficient. Adequate protocols for children with spinal injuries are currently unavailable.
Objective:
The aim of this study was (i) to develop a protocol that supports decision making for prehospital spinal immobilization in pediatric trauma patients based on evidence from current scientific literature and (ii) to perform a first analysis of the quality of results if the protocol is used by emergency personnel.
Material And Methods:
Based on a structured literature search a new immobilization protocol was developed. Analysis of the quality of results was performed by a questionnaire containing four case scenarios in order to assess correct decision making. The decision about spinal immobilization was made without and with the utilization of the protocol.
Results:
The E.M.S. IMMO Protocol Pediatric was developed based on the literature. The analysis of the quality of results was performed involving 39 emergency medicine providers. It could be shown that if the E.M.S. IMMO Protocol Pediatric was used, the correct type of immobilization was chosen more frequently. A total of 38 out of 39 participants evaluated the protocol as helpful.
Conclusion:
The E.M.S. IMMO Protocol Pediatric provides decision-making support whether pediatric spine immobilization is indicated with respect to the cardiopulmonary status of the patient. In a first analysis, the E.M.S. IMMO Protocol Pediatric improves decision making by emergency medical care providers.
