儿科创伤患者群体在复苏期间脊柱固定:呼吁改进指导方针
Tessa Breeding1, Hazem Nasef1, Quratulain Amin1
1NOVA Southeastern University, Kiran Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA.
The American journal of emergency medicine
|December 12, 2023
概括
儿科创伤患者的脊柱固定导致更多的成像和更高的入院率,与不一致的技术和频繁的失误. 需要进一步的研究,以获得最佳的儿科脊柱固定实践.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 紧急医疗 紧急医疗
- 整形外科手术 整形外科手术
背景情况:
- 脊柱固定是儿科创伤患者的常见做法.
- 目前关于其有效性和对结果的影响的证据有限.
研究的目的:
- 评估当前在儿科创伤中脊柱固定的实践.
- 评估这些实践的疗效,可靠性和临床影响.
- 以指导未来的研究和基于证据的指导方针.
主要方法:
- 对儿科脊柱不动化研究的系统综述.
- 搜索的数据库:PubMed,ProQuest,Embase,谷歌学者,Cochrane. 这些数据库的搜索内容包括:
- 评估结果:成像频率,疼痛,ED停留时间,处置.
主要成果:
- 固定儿童的宫脊椎成像率 (OR 8.2),地板入院率 (OR 4.0),ICU/OR入院率 (OR 5.3) 和疼痛评分都更高.
- 较大的孩子更有可能被动不动.
- 没有任何技术可以实现一致的中性定位; 71.4%的患者经历了固定失效.
结论:
- 儿科脊柱固定与成像增加,更高的入院率和更大的疼痛有关.
- 固定实践是不一致的,经常有失误和不良对齐.
- 需要进行进一步的研究,以确定儿科脊柱固定治疗的最佳技术和指示.
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