荒野医学会脊髓保护临床实践指南:2024年更新
Seth C Hawkins1, Jason Williams2, Brad L Bennett3
1Department of Emergency Medicine, Wake Forest University, Winston-Salem, NC.
Wilderness & environmental medicine
|February 21, 2024
概括
新的指导方针建议以目标为导向的脊髓保护,优先考虑患者的安全,而不是硬的固定技术,如在荒野环境中为潜在的脊髓损伤提供背板.
科学领域:
- 荒野医学 荒野医学
- 创伤管理 创伤管理
- 脊髓保护 脊髓保护
背景情况:
- 荒野医学会召集了一个专家小组,以更新脊髓保护指南.
- 准则是专门针对在荒野环境中管理受伤或可能受伤的脊柱.
研究的目的:
- 开发基于证据的指导方针,用于保护脊髓在荒野创伤.
- 更新最佳实践,考虑到患者和提供者安全.
主要方法:
- 一个专家小组更新了现有的指导方针,以2023年成为会员.
- 根据使用美国胸部医生学院的方法,根据证据质量对建议进行了分级.
- 干预措施的好处和风险/负担是平衡的.
主要成果:
- 干预措施应以目标为导向,重点关注在整体安全范围内保护脊髓/脊柱.
- 以目标为导向的方法与以技术为导向的方法形成对比,例如刚性固定.
- 基于证据的建议排除了可疑脊柱损伤的刚性领或背板.
结论:
- 在荒野创伤中保护脊髓需要从刚性固定转向以目标为导向的方法.
- 在决策过程中,患者和提供者安全至关重要.
- 目前的证据表明,在怀疑脊柱损伤的情况下,应避免使用领或背板进行例行固定.
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